Healthcare Provider Details

I. General information

NPI: 1437258209
Provider Name (Legal Business Name): TOD RUSSELL STORM DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E MAIN ST STE 2
BOZEMAN MT
59715-3823
US

IV. Provider business mailing address

401 S ALABAMA ST STE 10
BUTTE MT
59701-2358
US

V. Phone/Fax

Practice location:
  • Phone: 406-587-8478
  • Fax: 406-582-0730
Mailing address:
  • Phone: 406-587-8478
  • Fax: 406-582-0730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberMT129
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number129
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: