Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 4258 | MT |
NPI | 1003862749 |
---|---|
Provider Name | Robert D Schimpff |
First Address | Kalispell, MT 59901-3112 |
Second Address | Kalispell, MT 59901-3112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30549 | (05) | MT |
94641 | BLUE CROSS (01) | MT |
C64148 | (02) |