Southeastern Montana Surgical Associates PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

7804 Issued in MT

Legal business name

SOUTHEASTERN MONTANA SURGICAL ASSOCIATES PC

Practice address

2600 Wilson St
Miles City, MT 59301-5094

Phone

(406) 233-3030

Fax

(406) 233-3032

NPI assigned

Dec 29, 2009

Last updated

Dec 29, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David J Kaderis, D.O.

Title

President

Phone

(406) 233-3030

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1194055921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593010188",
            "telephone_number": "406-233-3030",
            "fax_number": "406-233-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 WILSON ST",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593015094",
            "telephone_number": "406-233-3030",
            "fax_number": "406-233-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN MONTANA SURGICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "KADERIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-233-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MT",
            "license": "7804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Miles City, MT
• Providers in Miles City, MT by specialty
• Surgery Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.