Organization · Type 2 NPI

Providence Health & Services MT

Family Medicine Physician · Missoula, MT

NPI number 1730802364 Active

Practice location

900 N Orange St Ste 303
Missoula, MT 59802-2956

Call (406) 327-7337 Map

Fax (406) 327-7373

Mailing address

PO Box 31001 - 4114
Pasadena, CA 91110-4114

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2 other providers at this address

Other family medicine physician providers in Missoula

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NPI record

NPI: 1730802364
Entity type: Organization (Type 2)
Issued: Sep 20, 2022
Last updated: May 7, 2025
Status: Active

Other names

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

Authorized official

Donald Wayne Anderson
Assistant Secretary Enrollment
(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 1730802364

Providence Health & Services MT's National Provider Identifier is 1730802364, issued on Sep 20, 2022. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Missoula, MT. The record was last updated on May 7, 2025.