Provider Demographics
NPI:1932352176
Name:SIMONS, MARILEE MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:MARILEE
Middle Name:MICHELLE
Last Name:SIMONS
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 1:915 HIGHLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6902
Mailing Address - Country:US
Mailing Address - Phone:406-414-1671
Mailing Address - Fax:
Practice Address - Street 1:905 HIGHLAND BLVD STE 4500
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6903
Practice Address - Country:US
Practice Address - Phone:406-414-5150
Practice Address - Fax:406-414-5155
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT36112207V00000X
UT7465104-1105207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTM011006971Medicaid