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NPI Code Detail

MEDICARE: DEL BREMER COOLIDGE M.D.

MEDICARE: DEL BREMER COOLIDGE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician3569MDMT

General Provider Information

NPI Number : 1104963610
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEL BREMER COOLIDGE M.D.
Provider Business Mailing Address
First Line : 1850 FOUR WHEEL DR
Second Line :
City : WHITEFISH
State : MT
Zip : 59937-8021
Country : US
Telephone Number : 406-862-7606
Fax Number : 406-873-5675
Provider Business Practice Location Address
First Line : 519 E MAIN ST
Second Line :
City : CUT BANK
State : MT
Zip : 59427-3015
Country : US
Telephone Number : 406-873-5670
Fax Number : 406-873-5675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 07/08/2007

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Directions to “ DEL BREMER COOLIDGE M.D.” Practice Location

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