Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Health & Services Mt

Organization Pediatrics Physician · NPI 1154562981

Providence Health & Services Mt is a Pediatrics Physician in Missoula, Montana. Registered with an NPI since 2009.

In the registry since
2009
Specialties on file
2

Practice location Address checks out

500 W Broadway St
Missoula, MT 59802-4096
Phone: (406) 327-1613
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X
Hospitalist Physician Taxonomy 208M00000X

Record details

NPI number1154562981
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Pmg Mt Pediatric Hospitalists; Providence Medical Group Montana
NPI enumeratedMarch 6, 2009
Last updated in NPPESMay 6, 2025
Certification dateMay 6, 2025
Mailing addressPo Box 31001 - 4114, Pasadena, CA 91110-4114

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