Healthcare Provider Details

I. General information

NPI: 1669472395
Provider Name (Legal Business Name): ROBERT ZELMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 05/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 28TH ST S SUITE 10
GREAT FALLS MT
59405-5296
US

IV. Provider business mailing address

PO BOX 6010
GREAT FALLS MT
59406-6010
US

V. Phone/Fax

Practice location:
  • Phone: 406-455-4320
  • Fax: 406-452-0769
Mailing address:
  • Phone: 406-455-4477
  • Fax: 406-268-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number11914
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: