Provider Demographics
NPI:1437165461
Name:CALDWELL, ROBERT II (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:CALDWELL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 MISSOULA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3801
Mailing Address - Country:US
Mailing Address - Phone:406-495-1515
Mailing Address - Fax:406-495-1520
Practice Address - Street 1:1125 MISSOULA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3801
Practice Address - Country:US
Practice Address - Phone:406-495-1515
Practice Address - Fax:406-495-1520
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT71362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000097556OtherBLUE CROSS-SHIELD OF MONT
MT000081858Medicare ID - Type Unspecified
MT011003050 C4MHMedicare PIN
MTA49367Medicare UPIN
MT011000638 C4MHMedicare PIN