Provider Demographics
NPI:1144310020
Name:MCCALL, MICHELLE C (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:C
Last Name:MCCALL
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 5179
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59604-5179
Mailing Address - Country:US
Mailing Address - Phone:406-495-7265
Mailing Address - Fax:406-443-4526
Practice Address - Street 1:1225 BIRCH ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-0617
Practice Address - Country:US
Practice Address - Phone:406-443-2977
Practice Address - Fax:406-443-2960
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT95602084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0140437Medicaid
MT0140437Medicaid