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General NPI Number Information
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NPI Number | 1811106891
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Entity Type | Individual
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Provider Name | ATARAH EVE MARTIN SIDEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 04/25/2022
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Provider Practice Location Address
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Address Line | 3800 EASTSIDE HWY
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City | STEVENSVILLE
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State | MT
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Zip | 59870-2221
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Country | US
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Telephone | 406-777-2775
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Fax | 406-777-2796
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Provider Business Mailing Address
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Address Line | 3800 EASTSIDE HWY
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City | STEVENSVILLE
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State | MT
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Zip | 59870-2221
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Country | US
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Telephone | 406-777-2775
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Fax | 406-777-2796
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD29451
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | LL16337
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 77537
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License Number State | MT
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