Individual
MARK PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 EASTSIDE HWY, STEVENSVILLE COMMUNITY MEDICAL CENTER, STEVENSVILLE, MT 59870
(406) 777-2775
(406) 777-2796
Mailing address
PO BOX 16900, MISSOULA, MT 59808-6900
(406) 327-4620
(406) 549-5928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MT5294
MT
207R00000X
Internal Medicine Physician
MT5294
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000095960
BCBS
MT
05
—
0076700
—
MT
Enumeration date
08/09/2006
Last updated
02/16/2010
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