Provider Demographics
NPI:1942295134
Name:KAHN, FREDERICK WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:WILLIAM
Last Name:KAHN
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 1:2900 12TH AVE N
Mailing Address - Street 2:SUITE 300E
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7506
Mailing Address - Country:US
Mailing Address - Phone:406-238-6800
Mailing Address - Fax:406-238-6814
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:SUITE 300E
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-238-6800
Practice Address - Fax:406-238-6814
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2009-11-13
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
MT5284207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0078637Medicaid
D20613Medicare UPIN
MT000922901Medicare ID - Type Unspecified