| Ravalli Family Medicine | |
|
411 W Main Street Hamilton MT 59840-2470 | |
| (406) 363-5104 | |
| (406) 363-2894 |
| Full Name | Ravalli Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 411 W Main Street, Hamilton, Montana |
| Authorized Official Name and Position | Kathleen A. Harder-bronwer (OWNER) |
| Authorized Official Contact | 4063635104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ravalli Family Medicine 411 W. Main Street Hamilton MT 59840-2470 Ph: (406) 363-5104 | Ravalli Family Medicine 411 W Main Street Hamilton MT 59840-2470 Ph: (406) 363-5104 |
| NPI Number | 1346326824 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 08/18/2014 |
| Medicare PECOS PAC ID | 3072407196 |
|---|---|
| Medicare Enrollment ID | O20040210000950 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346326824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lawrence D Brouwer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306922885 PECOS PAC ID: 0143114264 Enrollment ID: I20040217000168 |
| Provider Name | Kathleen A Harder-brouwer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730265208 PECOS PAC ID: 5597659623 Enrollment ID: I20040217000236 |
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