Provider Demographics
NPI:1114056967
Name:CARDIOPULMONARY ASSOCIATES OF MONTANA, PLLC
Entity Type:Organization
Organization Name:CARDIOPULMONARY ASSOCIATES OF MONTANA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:MALATARE
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:406-329-2887
Mailing Address - Street 1:601 W SPRUCE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4057
Mailing Address - Country:US
Mailing Address - Phone:406-329-2945
Mailing Address - Fax:406-329-2938
Practice Address - Street 1:601 W SPRUCE ST
Practice Address - Street 2:SUITE A
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4057
Practice Address - Country:US
Practice Address - Phone:406-329-2945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTD96056Medicare UPIN
MTE28047Medicare UPIN
MTD37535Medicare UPIN