MEDICARE: GRANT Y NAKAMURA MD

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	32057	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144233552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRANT Y NAKAMURA MD

Provider Business Mailing Address
First Line	:	144 2ND ST E STE 101
Second Line	:
City	:	WHITEFISH
State	:	MT
Zip	:	59937-2402
Country	:	US
Telephone Number	:	406-304-6898
Fax Number	:	406-235-7079

Provider Business Practice Location Address
First Line	:	144 2ND ST E STE 101
Second Line	:
City	:	WHITEFISH
State	:	MT
Zip	:	59937-2402
Country	:	US
Telephone Number	:	406-304-6898
Fax Number	:	406-235-7079

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	08/12/2020

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Directions to “ GRANT Y NAKAMURA MD” Practice Location

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