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NPI Code Detail

MEDICARE: MRS. PATRICIA JUNE PEZZAROSSI M.D.

MEDICARE: MRS. PATRICIA JUNE PEZZAROSSI 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
1208000000XPediatrics Physician6252MT

General Provider Information

NPI Number : 1568449411
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA JUNE PEZZAROSSI M.D.
Provider Business Mailing Address
First Line : 210 S WINCHESTER AVE
Second Line : 136
City : MILES CITY
State : MT
Zip : 59301-4742
Country : US
Telephone Number : 406-234-8793
Fax Number : 406-234-8796
Provider Business Practice Location Address
First Line : 210 S WINCHESTER AVE
Second Line : 136
City : MILES CITY
State : MT
Zip : 59301-4742
Country : US
Telephone Number : 406-234-8793
Fax Number : 406-234-8796
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 07/08/2007

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