Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 10299 | MT |
NPI | 1093826828 |
---|---|
Provider Name | Dana P. Damron |
First Address | Billings, MT 59107-5100 |
Second Address | Billings, MT 59101-0905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 03/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000094955 | BCBS PIN (01) | MT |
0064821 | MDCD PIN (01) | MT |
118794500 | MDCD PIN (01) | WY |
F20045 | (02) | MT |