OrganizationActive
Providence Health & Services Mt
NPI 1235370065 · Endocrinology, Diabetes & Metabolism Physician · Missoula, MT
Provider details
- NPI number
- 1235370065
- Entity type
- Organization
- Primary specialty
- Endocrinology, Diabetes & Metabolism 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
1st Floor
Missoula, MT 59802-4096
Phone: (406) 327-5734
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 31001 - 4114
Pasadena, CA 91110-4114
Other names (DBA / former)
- Doing business as
- Pmg Mt Wound Care
- Doing business as
- Pmg Mt Wound Care
- Doing business as
- Providence Medical Group Montana
Registry dates
- Enumerated
- 2009-03-06
- 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.