Healthcare Provider Details

I. General information

NPI: 1942242839
Provider Name (Legal Business Name): MARY REINDOLLAR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36928 JOE MCDONALD DRIVE
PABLO MT
59855
US

IV. Provider business mailing address

36928 JOE MCDONALD DRIVE
PABLO MT
59855
US

V. Phone/Fax

Practice location:
  • Phone: 406-275-2767
  • Fax: 406-226-2681
Mailing address:
  • Phone: 406-275-2767
  • Fax: 406-226-2681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMED-PAC-LIC-27350
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: