Provider Demographics
NPI:1770560948
Name:DEMALIGNON, BERNA ROIG (MD)
Entity type:Individual
Prefix:
First Name:BERNA
Middle Name:ROIG
Last Name:DEMALIGNON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BERNA
Other - Middle Name:
Other - Last Name:ROIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:202 2ND AVE S STE 103
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-1882
Mailing Address - Country:US
Mailing Address - Phone:064-991-3957
Mailing Address - Fax:
Practice Address - Street 1:202 2ND AVE S STE 103
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-1882
Practice Address - Country:US
Practice Address - Phone:406-991-3957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT57381208D00000X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
H90952Medicare UPIN
00A835482Medicare ID - Type UnspecifiedMEDICARE