Provider Demographics
NPI:1669511606
Name:KOLENDICH, CASEY J (MD)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:J
Last Name:KOLENDICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 7609
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59807-7609
Mailing Address - Country:US
Mailing Address - Phone:406-721-5600
Mailing Address - Fax:406-721-3907
Practice Address - Street 1:500 W. BROADWAY
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4008
Practice Address - Country:US
Practice Address - Phone:406-721-5600
Practice Address - Fax:406-329-7245
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2020-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT11522207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology