Organization · Type 2 NPI

Providence Health & Services MT

Obesity Medicine (Internal Medicine) Physician · Missoula, MT

NPI number 1124268982 Active

Practice location

500 W Broadway St, 4th Floor
Missoula, MT 59802-4096

Call (406) 329-5866 Map

Mailing address

PO Box 31001 - 4114
Pasadena, CA 91110-4114

Specialties and licenses

Taxonomy	Code	License
Obesity Medicine (Internal Medicine) Physician Primary	207RB0002X	None listed

Obesity Medicine (Internal Medicine) Physician: A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilize…

222 other providers at this address

NPI record

NPI: 1124268982
Entity type: Organization (Type 2)
Issued: Mar 5, 2009
Last updated: May 6, 2025
Status: Active
Subpart: Yes of Providence Health & Services

Other names

<unavail>
Providence Medical Group Montana · doing business as
PMG MT Bariatric Services · other name

Authorized official

Donald Wayne Anderson
Assistant Secretary Enrollments
(425) 358-9786

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1124268982

Providence Health & Services MT's National Provider Identifier is 1124268982, issued on Mar 5, 2009. The primary taxonomy on file is Obesity Medicine (Internal Medicine) Physician (207RB0002X), and the practice location is in Missoula, MT. The record was last updated on May 6, 2025.