Provider Demographics
NPI:1376544437
Name:SPETH, STEVEN R (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:SPETH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1450 ELLIS ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-8812
Mailing Address - Country:US
Mailing Address - Phone:406-587-0122
Mailing Address - Fax:
Practice Address - Street 1:1450 ELLIS ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8812
Practice Address - Country:US
Practice Address - Phone:406-587-0122
Practice Address - Fax:406-587-5548
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT8206207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT101286Medicaid
MTG34550Medicare UPIN
MT101286Medicaid