Provider Demographics
NPI:1710020029
Name:GLACIER CARDIOVASCULAR CONSULTANTS
Entity Type:Organization
Organization Name:GLACIER CARDIOVASCULAR CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIALL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MADIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-862-5355
Mailing Address - Street 1:PO BOX 3031
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903
Mailing Address - Country:US
Mailing Address - Phone:406-755-2823
Mailing Address - Fax:406-257-4820
Practice Address - Street 1:711 E 13TH STREET
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937
Practice Address - Country:US
Practice Address - Phone:406-862-5355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty