NPI 1124472964 · live from the CMS NPI Registry
Tanner Ferderer
Psychiatry & Neurology, Neurology in Kalispell, MT. National Provider Identifier 1124472964, active.
NPI record
| NPI | 1124472964 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 200 Commons Way Ste C, Kalispell, MT 59901 |
| Practice phone | 406-752-5095 |
| Enumerated | April 18, 2016 |
| Last updated | February 19, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology primary | 2084N0400X | MED-PHYS-LIC-99882 (MT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.