Organization · Type 2 NPI

Providence Health & Services MT

Endocrinology, Diabetes & Metabolism Physician · Missoula, MT

NPI number 1235370065 Active

Practice location

500 W Broadway St Ste 210
Missoula, MT 59802-4008

Call (406) 329-5736 Map

Mailing address

PO Box 31001 - 4114
Pasadena, CA 91110-4114

Specialties and licenses

Taxonomy	Code	License
Wound Care Registered Nurse	163WW0000X	None listed
Endocrinology, Diabetes & Metabolism Physician Primary	207RE0101X	None listed

Endocrinology, Diabetes & Metabolism Physician: An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

NPI record

NPI: 1235370065
Entity type: Organization (Type 2)
Issued: Mar 6, 2009
Last updated: Sep 16, 2026
Status: Active
Subpart: Yes of Providence Health & Services

Other names

<unavail>
PMG MT Wound Care · doing business as
PMG MT Wound Care · doing business as
Providence Medical Group Montana · doing business as

Authorized official

Donald W 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 1235370065

Providence Health & Services MT's National Provider Identifier is 1235370065, issued on Mar 6, 2009. The primary taxonomy on file is Endocrinology, Diabetes & Metabolism Physician (207RE0101X), and the practice location is in Missoula, MT. The record was last updated on Sep 16, 2026.