Healthcare Provider Details

I. General information

NPI: 1316188337
Provider Name (Legal Business Name): SHANNON SETZER M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2009
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 VALLEY COMMONS DR STE 202
BOZEMAN MT
59718-4532
US

IV. Provider business mailing address

4515 VALLEY COMMONS DR STE 202
BOZEMAN MT
59718-4532
US

V. Phone/Fax

Practice location:
  • Phone: 406-587-7546
  • Fax: 406-585-5672
Mailing address:
  • Phone: 406-587-7546
  • Fax: 406-585-5672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number11661
License Number StateMT

VIII. Authorized Official

Name: SHANNON VOIRIN SETZER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 406-587-7546