Organization
PROVIDENCE HEALTH & SERVICES MT
Active
Parent organization
PROVIDENCE HEALTH & SERVICES
Other names
PMG MT General Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES
Authorized official
TERI MASTERS (RCM OPERATIONS MGR)
(406) 329-5795
Entity
Organization
Contact information
Practice address
500 W BROADWAY ST, MISSOULA, MT 59802-4008
(406) 543-7271
Mailing address
PO BOX 34439, SEATTLE, WA 98124-1439
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
09/15/2010
Last updated
07/22/2011
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