DR. LARK GREENWALD GUSS (NPI# 1275973398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275973398 |
| Entity Type | Individual |
| Full Name | DR. LARK GREENWALD GUSS |
| Other Name | LARK JULIE GREENWALD |
| Credential | M.D. |
| Practice Address |
500 W Broadway St Missoula MT 59802 |
| Mailing Address |
Po Box 7609 Missoula MT 59807-7609 |
| Practice Telephone | 4067215600 |
| Mailing Telephone | 4067215600 |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2019-10-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 79073 | MT | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 148774 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 921340001 | 6195326411 |
| Street Address |
500 W BROADWAY ST |
| City | MISSOULA |
| State | MT |
| Zip Code | 59802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982600359 | Kendra B. Lee | Family Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2005-06-21 |
| 1205468725 | Stephanie Elizabeth Carl | Physician Assistant | 500 W Broadway St, Missoula, MT 59802-4008 | 2020-02-12 |
| 1942840483 | Credena Health LLC | Durable Medical Equipment & Medical Supplies | 500 W Broadway St, Missoula, MT 59802-4008 | 2020-01-13 |
| 1346880119 | Kaylyn Casebolt Desrosier | Pharmacist | 500 W Broadway St, Missoula, MT 59802-4008 | 2020-01-09 |
| 1689168049 | Kacia Bundle | Nurse Practitioner | 500 W Broadway St, Missoula, MT 59802-4008 | 2018-06-19 |
| 1114424488 | Hannah Gilliland | Nurse Practitioner | 500 W Broadway St, Missoula, MT 59802-4008 | 2018-04-12 |
| 1386164408 | Sandra Lynn Cummins | Social Worker | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-06-20 |
| 1548797152 | Joseph M Miller | Internal Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-05-12 |
| 1083147664 | Matthew Mcgady | Physician Assistant | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-04-10 |
| 1982135216 | Meeka Pradeep Gandhi | Pediatrics | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-03-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945921 | Montana Endoscopy Center, Pllc | Clinic/Center | 1930 W Broadway, Ste B, Missoula, MT 59802 | 2020-06-08 |
| 1194364091 | Tommie Lynn Perusich | Nurse Practitioner | 1120 Cedar St., Missoula, MT 59802 | 2019-12-26 |
| 1386122752 | The Hope Health Alliance, Inc. | Case Management | 314 White House Ln, Missoula, MT 59802 | 2018-07-30 |
| 1881181444 | Carol Anne Lesser | Massage Therapist | 1918 Birch St, Missoula, MT 59802 | 2018-04-19 |
| 1528587581 | Missoula Aids Fund, Inc. | Clinic/Center | 1500 W. Broadway Suite A, Missoula, MT 59802 | 2017-09-11 |
| 1942740667 | Gabrielle Shulman | Counselor | 415 N Higgins Ave Ste 14, Missoula, MT 59802 | 2017-02-28 |
| 1053798736 | Endurance Physio | Clinic/Center | 214 E. Main St, Missoula, MT 59802 | 2015-05-01 |
| 1720481971 | Anna Golding | Counselor | 1325 Wyoming Street, Missoula, MONTANA 59802 | 2014-10-02 |
| 1003255803 | Jennifer Dawn Danielson | Speech-Language Pathologist | 2408 Duncan Drive, Missoula, MT 59802 | 2013-06-14 |
| 1437595725 | Partnership Health Center Inc | Clinic/Center | 1150 Sherwood St, Missoula, MT 59802 | 2013-05-14 |
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| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750382842 | Robert J Korenberg | Dermatology | 1821 South Ave W Ste 402, Missoula, MT 59801-6518 | 2005-08-10 |
| 1457619033 | Jessica Kelly Sempler | Dermatology | 500 W Broadway St, Missoula, MT 59802 | 2012-05-02 |
| 1376835769 | Andrew R. Tegeder | Dermatology | 500 W Broadway St, Missoula, MT 59802-4008 | 2011-05-04 |
| 1609053511 | Robert Korenberg Md PC | Dermatology | 1821 South Ave W, Ste 402, Missoula, MT 59801-6517 | 2008-01-23 |
| 1356549406 | Shannon Kaye Foster | Dermatology | 500 W Broadway St, Missoula, MT 59802-4008 | 2007-07-10 |
| 1881750396 | Robert J Korenberg Md | Dermatology | 1821 South Ave W, Suite 402, Missoula, MT 59801-6517 | 2006-12-29 |
| 1518045731 | Lance Randall Hinther | Dermatology | 2825 Fort Missoula Road, Suite 201, Missoula, MT 59804 | 2006-11-02 |
| 1295815397 | Charlotte L Kutsch | Dermatology | 2835 Fort Missoula Rd, Ste 302, Missoula, MT 59804-7424 | 2006-10-16 |
| 1942217484 | Mark Lindsey Stewart | Dermatology | 2835 Fort Missoula Rd, Suite 302, Missoula, MT 59804-7424 | 2006-08-01 |
| 1841245503 | John W Gerwels | Dermatology | 500 West Broadway, Missoula, MT 59802-4008 | 2006-05-23 |
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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.