Individual
VENKATESH JAIRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 26TH ST S, GREAT FALLS, MT 59405-5161
(406) 455-4690
Mailing address
1101 26TH ST S, GREAT FALLS, MT 59405-5161
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24217
MT
Other
Enumeration date
05/29/2013
Last updated
05/29/2013
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