Individual
DR. BRENT MUIR ROSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2360 MULLAN RD STE C, MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-6053
Mailing address
2360 MULLAN RD, STE C, MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-6053
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
15371
NV
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
A130888
CA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
MD158161
OR
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
MED-PHYS-LIC-36762
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720222508
—
NV
Enumeration date
04/24/2009
Last updated
07/21/2022
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