Provider Demographics
NPI:1902053358
Name:REED, MICHAEL BRENDAN JAMES (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRENDAN JAMES
Last Name:REED
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 STOCKYARD RD STE J1
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1548
Mailing Address - Country:US
Mailing Address - Phone:406-721-1171
Mailing Address - Fax:
Practice Address - Street 1:2825 STOCKYARD RD STE J1
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1548
Practice Address - Country:US
Practice Address - Phone:406-721-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6850213ES0103X
UT7081425-0501213ES0103X
MT16274213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery