Provider Demographics
NPI:1003216409
Name:MONTANA NEUROLOGY & SLEEP MEDICINE, PC
Entity Type:Organization
Organization Name:MONTANA NEUROLOGY & SLEEP MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MULGREW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-431-1384
Mailing Address - Street 1:121 N LAST CHANCE GULCH
Mailing Address - Street 2:SUITE G2
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4159
Mailing Address - Country:US
Mailing Address - Phone:406-431-1384
Mailing Address - Fax:
Practice Address - Street 1:121 N LAST CHANCE GULCH
Practice Address - Street 2:SUITE G2
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4159
Practice Address - Country:US
Practice Address - Phone:406-431-1384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT106282084N0400X, 2084P2900X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty