Individual
ANN MARIE BUKACEK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
160 HERITAGE WAY, STE. 102, KALISPELL, MT 59901-3161
(406) 755-7785
(406) 755-7857
Mailing address
160 HERITAGE WAY, STE. 102, KALISPELL, MT 59901-3127
(406) 755-7785
(406) 755-7857
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6869
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0063665
—
MT
01
—
94705
BC/BS
MO
Enumeration date
02/07/2006
Last updated
07/08/2007
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