Provider Demographics
NPI:1922279512
Name:BINGHAM, NATHAN CHRISTIAN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:CHRISTIAN
Last Name:BINGHAM
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CONWAY DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3153
Mailing Address - Country:US
Mailing Address - Phone:406-758-7490
Mailing Address - Fax:
Practice Address - Street 1:202 CONWAY DR
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3153
Practice Address - Country:US
Practice Address - Phone:406-758-7490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD50214208000000X, 2080P0205X
OH35.0967992080P0205X, 2080P0205X
KY440592080P0205X
MTMED-PHYS-LIC-882302080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics