MEDICARE: PATRICK ROBERT DANAHER D.O.

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	10695	MT
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	10695	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992794010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK ROBERT DANAHER D.O.

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	:

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	:	406-728-8420
Fax Number	:

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	09/28/2012

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