Provider Demographics
NPI:1497012009
Name:SWEATMAN, ROLAND (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:
Last Name:SWEATMAN
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 1:255 SWAMP CREEK LOOP ROAD
Mailing Address - Street 2:
Mailing Address - City:TROUT CREEK
Mailing Address - State:MT
Mailing Address - Zip Code:59874-9552
Mailing Address - Country:US
Mailing Address - Phone:406-827-8787
Mailing Address - Fax:
Practice Address - Street 1:1410 STANLEY ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-3312
Practice Address - Country:US
Practice Address - Phone:406-721-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4232208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice