Provider Demographics
NPI:1316929409
Name:FEHIR, KIM (MD)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:FEHIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30976
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-0976
Mailing Address - Country:US
Mailing Address - Phone:406-238-6290
Mailing Address - Fax:406-238-6961
Practice Address - Street 1:532 VAL VISTA ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-3655
Practice Address - Country:US
Practice Address - Phone:307-674-5400
Practice Address - Fax:600-767-4540
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY6025A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0049114Medicaid
WY308265OtherBLUE CROSS
810511516008OtherEBMS
MT0049114Medicaid
WY308265OtherBLUE CROSS