Healthcare Provider Details

I. General information

NPI: 1326094749
Provider Name (Legal Business Name): MICHAEL ROBERT TRYHUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 S RUSSELL ST
MISSOULA MT
59801-8536
US

IV. Provider business mailing address

2540 WINDEMERE CT
MISSOULA MT
59804-9010
US

V. Phone/Fax

Practice location:
  • Phone: 406-721-4386
  • Fax:
Mailing address:
  • Phone: 406-543-9432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number8616
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number8616
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: