ANNE MANKTELOW (NPI# 1144230368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144230368 |
Entity Type | Individual |
Full Name | ANNE MANKTELOW |
Credential | MD |
Practice Address |
2835 Fort Missoula Road Ste 306 Pediatric Surgery of Montana Missoula MT 59804 |
Mailing Address |
Po Box 16900 Missoula MT 59808 |
Practice Telephone | 4063274730 |
Mailing Telephone | 4063274620 |
Mailing Fax Number | 4065495928 |
Enumeration Date | 2006-08-09 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
MT10170 | MT | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MT | 0096560 | 05 |
Street Address |
2835 FORT MISSOULA ROAD STE 306 PEDIATRIC SURGERY OF MONTANA |
City | MISSOULA |
State | MT |
Zip Code | 59804 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841247467 | Dirk R Gottman | Pediatrics | 2835 Fort Missoula Road, Missoula, MT 59804-7408 | 2006-05-28 |
1255361499 | Georgia G Maynard | Nurse Practitioner | 2835 Fort Missoula Road, Missoula, MT 59804-7408 | 2006-07-04 |
1528002821 | Kristene A Provo | Physician Assistant | 2835 Fort Missoula Road, Missoula, MT 59804-7408 | 2006-06-16 |
1346281359 | Lindsay A Richards | Obstetrics & Gynecology | 2835 Fort Missoula Road, Missoula, MT 59804-7408 | 2006-06-09 |
1457391203 | Eric J Kress | Family Medicine | 2835 Fort Missoula Road, Missoula, MT 59804-7408 | 2006-06-08 |
1235179508 | Kathleen S Rogers | Pediatrics | 2835 Fort Missoula Road, Missoula, MT 59804-7408 | 2006-06-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063019297 | Momentum Speech Therapy, PC | Speech-Language Pathologist | 9885 O'brien Creek Road, Missoula, MT 59804 | 2020-10-01 |
1033633037 | Marissa Clark | Genetic Counselor, MS | 2827 Fort Missoula Rd., Suite 317, Missoula, MT 59804 | 2017-08-01 |
1104295245 | Scott Richter | Specialist/Technologist | 2892 Ringo Dr, Missoula, MT 59804 | 2015-09-18 |
1467860353 | Zachary Ueland | Pharmacist | 4000 Highway 93 South, Missoula, MT 59804 | 2014-07-24 |
1316378185 | Tracy Laurel Brothers | Counselor | 1305 Wyoming Street, Missoula, MT 59804 | 2013-12-04 |
1447683651 | Granite Pharmacy Missoula, LLC | Durable Medical Equipment & Medical Supplies | 2230 27th Ave. West, Suite 2, Missoula, MT 59804 | 2013-08-12 |
1871843953 | Autum Emerson Howell | Nurse Practitioner | 2831 Ft. Missoula Rd. Bldg 2, 102, Missoula, MT 59804 | 2012-09-14 |
1821353939 | Carlyn Doyle | Nurse Practitioner | 2835 Fort Missoula Rd Ste 203, Missoula, MT 59804 | 2012-07-05 |
1396011961 | Patricia Jean Evans | Internal Medicine | 702 S.w. Higgins, First Choice Medical Clinic, Missoula, MT 59804 | 2012-03-28 |
1205126794 | Pacific Medical, Inc. | Prosthetic/Orthotic Supplier | 2732 South Ave West, Suite 202, Missoula, MT 59804 | 2011-04-18 |
Find all providers in zip 59804 |
Taxonomy Code | 2086S0120X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Pediatric Surgery |
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770716201 | Gavin Alexander Falk | Surgery | 1333 Surgical Services Drive, Northwest Montana Surgical Associates, Kalispell, MT 59901 | 2009-09-01 |
1255332102 | Glenn A Winslow | Surgery | 3000 15th Avenue South, Great Falls, MT 59405 | 2005-08-02 |
1740413061 | Federico Gian Filippo Seifarth | Surgery | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2009-09-03 |
1437129046 | Scott William Lucas | Surgery | 3000 15th Ave S, Great Falls, MT 59405 | 2006-01-25 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.