MEDICARE: MICHAEL J NOUD 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	207L00000X	Anesthesiology Physician	MD069096L	PA
2	207L00000X	Anesthesiology Physician	MED-PHYS-LIC-10277	MT

General Provider Information

NPI Number	:	1972593754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J NOUD MD

Provider Business Mailing Address
First Line	:	PO BOX 24823
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-0823
Country	:	US
Telephone Number	:	425-407-1500
Fax Number	:	425-407-1112

Provider Business Practice Location Address
First Line	:	310 SUNNYVIEW LN
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-3129
Country	:	US
Telephone Number	:	406-752-5111
Fax Number	:

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	08/07/2013

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