Provider Demographics
NPI:1295736171
Name:BRAGET, DAREN J (MD)
Entity type:Individual
Prefix:
First Name:DAREN
Middle Name:J
Last Name:BRAGET
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 1:1400 29TH ST S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5316
Mailing Address - Country:US
Mailing Address - Phone:406-761-7924
Mailing Address - Fax:406-761-7924
Practice Address - Street 1:1400 29TH ST S
Practice Address - Street 2:SUITE 101
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5316
Practice Address - Country:US
Practice Address - Phone:406-761-7924
Practice Address - Fax:406-761-7924
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT9952207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0040742Medicaid
MT0040742Medicaid
MT000082237Medicare ID - Type Unspecified