Individual
FREDERICK TAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2230 N RESERVE ST, MISSOULA, MT 59808-1321
(406) 327-3850
(406) 327-3851
Mailing address
PO BOX 16900, MISSOULA, MT 59808
(406) 327-4620
(406) 549-5928
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
8751
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000092256
BCBS
MT
05
—
0150540
—
MT
Enumeration date
09/15/2006
Last updated
03/15/2011
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