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NPI Code Detail

MEDICARE: DANIELLE MAESTAS PA-C

MEDICARE: DANIELLE MAESTAS PA-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
1363AM0700XMedical Physician Assistant50.004901RXOH
2363AM0700XMedical Physician AssistantMED-PAC-LIC-88688MT

General Provider Information

NPI Number : 1962850479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE MAESTAS PA-C
Provider Business Mailing Address
First Line : 1501 SAINT CHARLES ST
Second Line :
City : FORT BENTON
State : MT
Zip : 59442-7710
Country : US
Telephone Number : 406-622-5485
Fax Number :
Provider Business Practice Location Address
First Line : 1501 SAINT CHARLES ST
Second Line :
City : FORT BENTON
State : MT
Zip : 59442-7710
Country : US
Telephone Number : 406-622-3331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2016
Last Update Date : 12/08/2020

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Directions to “ DANIELLE MAESTAS PA-C” Practice Location

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