Provider Demographics
NPI:1457313082
Name:SPRING, MICHELLE A (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:A
Last Name:SPRING
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 1:60 FOUR MILE DR STE 11
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2663
Mailing Address - Country:US
Mailing Address - Phone:406-609-0210
Mailing Address - Fax:406-609-0211
Practice Address - Street 1:60 FOUR MILE DR STE 11
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2663
Practice Address - Country:US
Practice Address - Phone:406-609-0210
Practice Address - Fax:406-609-0211
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT37175208200000X, 2086S0122X
WI44936-0202086S0122X
CAA941362086S0122X
IDM106712086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP00750748OtherRAIL ROAD MEDICARE
ID000010174305OtherREGENCE BLUE SHIELD
WI34751000Medicaid
ID77937OtherBLUE CROSS OF IDAHO
ID808322600Medicaid
ID77937OtherBLUE CROSS OF IDAHO
ID808322600Medicaid