Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 758 | ME |
N | 207QS0010X | Family Doctor - Sports Medicine | 77129 | MT |
NPI | 1023134293 |
---|---|
Provider Name | Brian W Abbott |
First Address | Helena, MT 59602-7804 |
Second Address | Helena, MT 59602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 02/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1619166972 | (05) | MT |