Provider Demographics
NPI:1750434676
Name:ENGAN, CHAD M (MD FACS)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:M
Last Name:ENGAN
Suffix:
Gender:M
Credentials:MD FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 13TH AVE S
Mailing Address - Street 2:SUITE 102 GREAT FALLS SURGICAL ASSOCIATES
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4300
Mailing Address - Country:US
Mailing Address - Phone:406-452-0877
Mailing Address - Fax:406-452-2989
Practice Address - Street 1:400 13TH AVE S STE 102
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4300
Practice Address - Country:US
Practice Address - Phone:406-731-8888
Practice Address - Fax:406-731-8318
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10335208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000099385OtherBLUE CROSS BLUE SHIELD
MT608333600OtherUS DEPT OF LABOR
MT0000095421Medicaid
MTP00199129OtherRAILROAD MEDICARE
MT010721166OtherEIN
MT010721166OtherEIN
MT608333600OtherUS DEPT OF LABOR