Individual
DIRK R GOTTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W BROADWAY ST, MISSOULA, MT 59802-4008
(406) 721-5600
(406) 329-7131
Mailing address
PO BOX 7609, MISSOULA, MT 59807-7609
(406) 721-5600
(406) 721-3907
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9637
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0028815
—
MT
Enumeration date
05/28/2006
Last updated
09/16/2021
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