Provider Demographics
NPI:1477650844
Name:NAUTS, DANIEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:NAUTS
Suffix:
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 1:1201 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801
Mailing Address - Country:US
Mailing Address - Phone:406-532-9900
Mailing Address - Fax:406-532-9901
Practice Address - Street 1:1201 WYOMING ST.
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801
Practice Address - Country:US
Practice Address - Phone:406-532-9900
Practice Address - Fax:406-532-9901
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT73972084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000917530OtherBLUE CROSS-SHIELD OF MONTANA CENTER FOR MENTAL HEALTH
MTP01206034 C01340OtherRAILROAD MEDICARE FOR C4MH
MTXN6287507OtherDEA
MTP01206034 C01340OtherRAILROAD MEDICARE FOR C4MH
MTXN6287507OtherDEA
MTM011002218 C4MHMedicare PIN
MTA09478Medicare UPIN