Provider Demographics
NPI:1619074564
Name:CASPER, MELISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:CASPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1288 N 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-8533
Mailing Address - Country:US
Mailing Address - Phone:406-587-0681
Mailing Address - Fax:406-587-9011
Practice Address - Street 1:1288 N 14TH AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8533
Practice Address - Country:US
Practice Address - Phone:406-587-0681
Practice Address - Fax:406-587-9011
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9871207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000095276OtherBCBS
011000219Medicare PIN
000095276OtherBCBS