Individual
J MATTHEW MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 HERITAGE WAY STE 2100, KALISPELL, MT 59901-3167
(406) 257-8993
(406) 257-8996
Mailing address
4300 DUNCAN DR, MISSOULA, MT 59802-3290
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MED-PHYS-LIC-8175
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108602
—
MT
Enumeration date
06/28/2006
Last updated
02/19/2024
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