MEDICARE: MAPG, P.C.

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	207L00000X	Anesthesiology Physician
2	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1578516480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAPG, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 17377
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-7377
Country	:	US
Telephone Number	:	406-728-8420
Fax Number	:	406-541-8430

Provider Business Practice Location Address
First Line	:	2835 FORT MISSOULA RD
Second Line	:	SUITE 102
City	:	MISSOULA
State	:	MT
Zip	:	59804-7423
Country	:	US
Telephone Number	:	406-541-7246
Fax Number	:	406-541-8430

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	BARBARA GILLETT-BRETZ
Credential	:
Telephone Number	:	406-728-8420

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	05/11/2015

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Directions to “MAPG, P.C. ” Practice Location

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