Provider Demographics
NPI:1780685636
Name:ORCUTT, MICHAEL B (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:B
Last Name:ORCUTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 29TH ST S STE 201
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5316
Mailing Address - Country:US
Mailing Address - Phone:406-727-8346
Mailing Address - Fax:406-727-3932
Practice Address - Street 1:1400 29TH ST S STE 201
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5316
Practice Address - Country:US
Practice Address - Phone:406-727-8346
Practice Address - Fax:406-727-3932
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT51632086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0086008Medicaid
D96306Medicare UPIN
MT000198901Medicare ID - Type Unspecified