Provider Demographics
NPI:1568654226
Name:ANNETTE WAHL, MD, PC
Entity Type:Organization
Organization Name:ANNETTE WAHL, MD, PC
Other - Org Name:ANNETTE COMES, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:COMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-538-1515
Mailing Address - Street 1:310 WENDELL AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-2267
Mailing Address - Country:US
Mailing Address - Phone:406-538-1515
Mailing Address - Fax:406-538-6319
Practice Address - Street 1:310 WENDELL AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-2267
Practice Address - Country:US
Practice Address - Phone:406-538-1515
Practice Address - Fax:406-538-6319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9585207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty