Organization
THOMAS A. BAUMGARTNER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN MARICELLI (OFFICE MANAGER)
(406) 542-2116
Entity
Organization
Contact information
Practice address
2825 FORT MISSOULA RD, SUITE 304, MISSOULA, MT 59804-7420
(406) 542-2116
(406) 542-1425
Mailing address
2825 FORT MISSOULA RD, SUITE 304, MISSOULA, MT 59804-7420
(406) 542-2116
(406) 542-1425
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4051
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000011090
BCBS
—
05
—
0056784
—
MT
01
—
160055069
MEDICARE RAILROAD
—
Enumeration date
11/07/2008
Last updated
02/19/2009
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