Healthcare Provider Details

I. General information

NPI: 1497869572
Provider Name (Legal Business Name): MARTIN A KURLAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 01/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 3RD ST S
GLASGOW MT
59230-2604
US

IV. Provider business mailing address

PO BOX 307
GLASGOW MT
59230-0307
US

V. Phone/Fax

Practice location:
  • Phone: 406-228-3500
  • Fax: 406-228-3533
Mailing address:
  • Phone: 406-228-3500
  • Fax: 406-228-3533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number7706
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number7706
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number7706
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number7706
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: