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Individual

CAMILLA E JUHL-PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
500 W BROADWAY ST, MISSOULA, MT 59802-4008
(406) 543-7271
(406) 327-1834
Mailing address
500 WEST BROADWAY, MISSOULA, MT 59802-4008
(406) 327-1918
(406) 549-2246

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6049
AK
207Q00000X
Family Medicine Physician
Primary
MED-PHYS-LIC-49461
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MD9656
AK
Enumeration date
06/24/2011
Last updated
10/18/2022
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