Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 98511 | MT |
N | 207ND0101X | MOHS-Micrographic Surgeon | 98511 | MT |
N | 208D00000X | General Practice Physician | 98511 | MT |
NPI | 1205362043 |
---|---|
Provider Name | Dr. Eric L. Maranda |
First Address | Billings, MT 59102-6889 |
Second Address | Billings, MT 59102-6889 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2017 |
Last Update Date | 08/02/2022 |