Grace, Andrew W
Grace, Andrew W is an sole proprietor health care provider with primary practice located at 905 Highland Blvd Ste 4450, Bozeman MT 59715-6901. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Phlebology, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Grace, Andrew W can be contacted via phone (406) 585-5037.Contact Information
Primary practice address
905 Highland Blvd Ste 4450
Bozeman MT 59715-6901
Phone: (406) 585-5037
Fax: (406) 556-5295
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Phlebology | 202K00000X | 10338 | Montana |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 10338 | Montana |
Profile Details
| NPI number | 1437154291 |
|---|---|
| LBN Legal business name | Grace, Andrew W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 17th, 2005 |
| Last updated | Jan 29th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437154291 | NPPES |
| Montana | Other | 45-2860317 | TAX ID |
| Montana | MEDICAID | 0062917 | TAX ID |
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