Provider Demographics
NPI:1841382207
Name:BRESLOW, MICHAEL FRANK (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FRANK
Last Name:BRESLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LIBBY
Mailing Address - State:MT
Mailing Address - Zip Code:59923-2010
Mailing Address - Country:US
Mailing Address - Phone:406-293-6900
Mailing Address - Fax:
Practice Address - Street 1:320 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LIBBY
Practice Address - State:MT
Practice Address - Zip Code:59923-2010
Practice Address - Country:US
Practice Address - Phone:406-293-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ152212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry