Individual
LAWRENCE DALE BROUWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
411 W MAIN ST, HAMILTON, MT 59840-2470
(406) 363-5104
(406) 363-2894
Mailing address
411 W MAIN ST, HAMILTON, MT 59840-2470
(406) 363-5104
(406) 363-2894
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9684
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0069134
—
MT
01
—
A002
TRICARE
MT
Enumeration date
10/27/2006
Last updated
07/08/2007
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