Healthcare Provider Details

I. General information

NPI: 1669528287
Provider Name (Legal Business Name): ERIK PELTZ DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 SURGICAL SERVICES WAY
KALISPELL MT
59901-4844
US

IV. Provider business mailing address

1333 SURGICAL SERVICES WAY
KALISPELL MT
59901-4844
US

V. Phone/Fax

Practice location:
  • Phone: 406-752-5000
  • Fax: 406-752-8220
Mailing address:
  • Phone: 406-752-5000
  • Fax: 406-752-8220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number48204
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMED-PHYS-LIC-77210
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: