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General NPI Number Information
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NPI Number | 1073932398
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Entity Type | Individual
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Provider Name | DANIEL SELVIG M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 1930 W BROADWAY ST STE A
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City | MISSOULA
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State | MT
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Zip | 59808-1960
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Country | US
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Telephone | 406-541-6844
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Fax | 406-541-6843
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Provider Business Mailing Address
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Address Line | 1930 W BROADWAY ST STE A
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City | MISSOULA
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State | MT
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Zip | 59808-1960
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Country | US
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Telephone | 406-541-6844
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Fax | 406-541-6843
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A141119
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A141119
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MED-PHYS-LIC-143554
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License Number State | MT
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