Individual
DR. JENNIFER BURCH MAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 W BROADWAY ST, MISSOULA, MT 59802-4008
(406) 721-5600
(406) 329-7103
Mailing address
PO BOX 7609, MISSOULA, MT 59807-7609
(406) 721-5600
(406) 721-3907
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
12428
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437353232
—
MT
Enumeration date
06/14/2007
Last updated
06/25/2021
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