Mark S Woltanski, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4975 Issued in MT

Practice address

2901 Brooks St
Missoula, MT 59801-7722

Phone

(406) 721-0918

Fax

(406) 721-1654

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912934720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7609",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598077609",
            "telephone_number": "406-721-5600",
            "fax_number": "406-721-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 BROOKS ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598017722",
            "telephone_number": "406-721-0918",
            "fax_number": "406-721-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTANSKI",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "4975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0045500",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zackery W Witte, M.D.
• Carissa Marie Woelich, OD
• Christian Wold, LMSW
• Rochelle Suzanne Wolfe, M.D.
• Danette M Wollersheim, PHD
• Douglas Keith Womack, L.AC.
• Womens Counseling Center P.C.
• Womens Health LLC
• Gregory A Wood, M.D.
• John Wood II, SWLC

• Family Medicine Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.