OrganizationActive
Providence Health & Services Mt
NPI 1124268982 · Obesity Medicine (Internal Medicine) Physician · Missoula, MT
Provider details
- NPI number
- 1124268982
- Entity type
- Organization
- Primary specialty
- Obesity Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Providence Health & Services
- Organization subpart
- Yes
- Authorized official
- Donald Anderson, Assistant Secretary Enrollments(425) 358-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
500 W Broadway St
4th Floor
Missoula, MT 59802-4096
Phone: (406) 329-5866
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 31001 - 4114
Pasadena, CA 91110-4114
Other names (DBA / former)
- Other name
- Pmg Mt Bariatric Services
- Doing business as
- Providence Medical Group Montana
Registry dates
- Enumerated
- 2009-03-05
- Last updated
- 2025-05-06
- Certified
- 2025-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.