Mortenson, Dale R

Mortenson, Dale R is an individual health care provider with primary practice located at 400 13Th Ave S Ste 102 , Great Falls MT 59405-4300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mortenson, Dale R can be contacted via phone (406) 731-8888.

Contact Information

Primary practice address
400 13Th Ave S Ste 102 Great Falls MT 59405-4300
Phone: (406) 731-8888
Fax: (406) 731-8318
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 7773 Montana

Profile Details

NPI number 1801949722
LBN Legal business name Mortenson, Dale R
Credentials MD, FACS
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated May 22nd, 2024 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801949722 NPPES
Montana Other 0000099960 BLUE CROSS BLUE SHIELD
Montana Other 020053444 BLUE CROSS BLUE SHIELD
Montana Other 608333600 BLUE CROSS BLUE SHIELD
Montana MEDICAID 0000048433 BLUE CROSS BLUE SHIELD

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