Provider Demographics
NPI:1386777431
Name:BARSTAD, CHRISTINE RAGAN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:RAGAN
Last Name:BARSTAD
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 1:2835 FORT MISSOULA RD
Mailing Address - Street 2:SUITE 303, PHYSICIAN CENTER 3
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-7423
Mailing Address - Country:US
Mailing Address - Phone:406-541-2215
Mailing Address - Fax:406-541-2217
Practice Address - Street 1:2835 FORT MISSOULA RD
Practice Address - Street 2:SUITE 303, PHYSICIAN CENTER 3
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-7423
Practice Address - Country:US
Practice Address - Phone:406-541-2215
Practice Address - Fax:406-541-2217
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10069207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTG71331Medicare UPIN