Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 7972 | MT |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 7972 | MT |
NPI | 1144300526 |
---|---|
Provider Name | Dr. Nick M Digiovine |
First Address | Butte, MT 59701-1515 |
Second Address | Butte, MT 59701-1515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 16/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000011051 | BLUE CROSS BLUE SHIELD (01) | MT |
0017316 | (05) | MT |
01120625 | MONTANA STATE IAB (01) | MT |
E55557 | (02) | MT |