Organization
MALTA MEDICAL ASSOCIATES, LLC
Active
Other names
Malta Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN MEDINA MD (PRESIDENT/CHIEF MEDICAL OFFICER)
(406) 654-2878
Entity
Organization
Contact information
Practice address
801 S 3RD ST E RM 304, MALTA, MT 59538-8769
(406) 654-2878
(406) 654-2810
Mailing address
PO BOX 1235, MALTA, MT 59538-1235
(406) 654-2878
(406) 654-2018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000922611
BLUE CROSS BLUE SHIELD
MT
05
—
0028223
—
MT
05
—
0720001
—
MT
05
—
G414566
—
MT
Enumeration date
03/11/2022
Last updated
04/03/2025
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