MEDICARE: JOHANNA DREILING 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
1	207Q00000X	Family Medicine Physician	12495	MT

General Provider Information

NPI Number	:	1114174414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHANNA DREILING M.D.

Provider Business Mailing Address
First Line	:	623 S 4TH ST
Second Line	:
City	:	HAMILTON
State	:	MT
Zip	:	59840-2740
Country	:	US
Telephone Number	:	406-544-0295
Fax Number	:

Provider Business Practice Location Address
First Line	:	623 S 4TH ST
Second Line	:
City	:	HAMILTON
State	:	MT
Zip	:	59840-2740
Country	:	US
Telephone Number	:	406-544-0295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	01/14/2026

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