Healthcare Provider Details

I. General information

NPI: 1548261274
Provider Name (Legal Business Name): ROBERT M GRASSESCHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 25TH ST S STE 4
GREAT FALLS MT
59405-5183
US

IV. Provider business mailing address

PO BOX 6010
GREAT FALLS MT
59406-6010
US

V. Phone/Fax

Practice location:
  • Phone: 406-455-4300
  • Fax: 406-455-4310
Mailing address:
  • Phone: 406-455-4477
  • Fax: 406-268-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number10267
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number10267
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: