Provider Demographics
NPI:1376574871
Name:MENTEL, MARC C (DO)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:C
Last Name:MENTEL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:96 N WEAVER ST UNIT 440
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-7018
Mailing Address - Country:US
Mailing Address - Phone:406-219-7233
Mailing Address - Fax:888-798-0145
Practice Address - Street 1:1201 WYOMING ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-1727
Practice Address - Country:US
Practice Address - Phone:406-532-9900
Practice Address - Fax:406-532-9901
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-05-16
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Provider Licenses
StateLicense IDTaxonomies
MT105842084P0800X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0079186Medicaid
MT0079186Medicaid
MT000084059Medicare ID - Type Unspecified