MEDICARE: RONALD T. EGAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	8018	MT
2	2085R0204X	Vascular & Interventional Radiology Physician	8018	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295820025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD T. EGAN MD

Provider Business Mailing Address
First Line	:	5 BOB MARSHALL PL
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-6432
Country	:	US
Telephone Number	:	406-727-5939
Fax Number	:	406-727-5939

Provider Business Practice Location Address
First Line	:	5 BOB MARSHALL PL
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-6432
Country	:	US
Telephone Number	:	406-727-5939
Fax Number	:	406-727-5939

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	02/06/2012

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