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Individual

MARK KANETA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
310 SUNNYVIEW LN, KALISPELL, MT 59901-3129
(406) 751-5391
(406) 751-2988
Mailing address
310 SUNNYVIEW LN, KALISPELL, MT 59901-3129
(406) 751-5391
(406) 751-2988

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
9820
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000096141
BCBS
MT
05
0038046
MT
Enumeration date
08/09/2006
Last updated
06/20/2016
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