Individual
MICHAEL A JASUMBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 26TH ST S, GREAT FALLS, MT 59405-5161
(406) 455-5200
Mailing address
1101 26TH ST S, GREAT FALLS, MT 59405-5161
(406) 455-5200
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A64035
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A640350
BLUE SHIELD
CA
05
—
00A640350
—
CA
05
—
1114947843
—
MT
Enumeration date
07/19/2006
Last updated
04/08/2024
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