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Individual

DR. MICHAEL STEPHEN KORNISH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
107 6TH AVE SW, RONAN, MT 59864-2634
(406) 676-4441
(406) 676-0835
Mailing address
111 APPLE HOUSE LN, MISSOULA, MT 59802-3324
(406) 493-6318
(406) 493-6318

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
7286
MT
207Q00000X
Family Medicine Physician
7286
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43367
MT
Enumeration date
11/01/2006
Last updated
02/26/2008
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