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General NPI Number Information
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NPI Number | 1427469725
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Entity Type | Organization
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Legal Business Name | BELLAMAH VEIN & SURGERY, PLLC
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 2975 STOCKYARD RD SUITE 200 & 201
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City | MISSOULA
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State | MT
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Zip | 59808-1557
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Country | US
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Telephone | 513-509-1706
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Fax |
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Provider Business Mailing Address
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Address Line | 2975 STOCKYARD RD SUITE 200
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City | MISSOULA
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State | MT
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Zip | 59808-1557
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Country | US
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Telephone | 513-509-1706
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID HOWARD BELLAMAH
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Credential | M.D
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Telephone | 513-509-1706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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