David M Kidder, DO

Individual provider Active NPI Emergency Medical Services (Emergency Medicine) Physician · Anaconda, MT

NPI 1346293149 · NPPES record last updated Jul 7, 2014

Key facts

NPI
1346293149
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
License
4425 (MT)
Practice address
401 W Pennsylvania St
Anaconda, MT 59711-1931
Phone
(406) 563-8500
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4425MTMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 4425 MT Yes

Addresses

Primary practice location

401 W Pennsylvania St
Anaconda, MT 59711-1931

Mailing address

401 W Pennsylvania St
Anaconda, MT 59711-1931
Phone (406) 563-8500

Other identifiers

IdentifierTypeStateIssuer
1346293149OtherMT1346293149

Other providers in Anaconda, MT

All providers in Anaconda, MT · Emergency Medical Services (Emergency Medicine) Physician in Montana

Sources for this page

Verify at the official NPI Registry.