Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 10965 | MT |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 4301047622 | MI |
NPI | 1225023039 |
---|---|
Provider Name | Dr. Gregory O Utter |
First Address | Missoula, MT 59808-6900 |
Second Address | Missoula, MT 59804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 30/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2652653 | (05) | MI |
4301047622 | CONTROLLED SUBSTANCE (01) | |
BU149517 | DEA (01) | |
F01788 | (02) |