Provider Demographics
NPI:1154322873
Name:GARVER, MICHAEL K (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:K
Last Name:GARVER
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:926 13TH AVE S
Mailing Address - Street 2:PREMIER CARE PEDIATRICS
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4406
Mailing Address - Country:US
Mailing Address - Phone:406-770-3000
Mailing Address - Fax:406-770-3146
Practice Address - Street 1:926 13TH AVE S
Practice Address - Street 2:PREMIER CARE PEDIATRICS
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4406
Practice Address - Country:US
Practice Address - Phone:406-770-3000
Practice Address - Fax:406-770-3146
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2014-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT8726208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0018190Medicaid
MT0117062Medicaid
MT0117062Medicaid
MT0018190Medicaid