Healthcare Provider Details

I. General information

NPI: 1255424354
Provider Name (Legal Business Name): MARGARET LILLIAN CARNEGIE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N ORANGE ST SUITE 103 AND 106
MISSOULA MT
59802-2998
US

IV. Provider business mailing address

P.O. BOX 1 2
LIBERTY LAKE WA
99019-0012
US

V. Phone/Fax

Practice location:
  • Phone: 406-327-3057
  • Fax: 406-327-3231
Mailing address:
  • Phone: 406-327-1918
  • Fax: 406-329-2937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD058235L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: