Provider Demographics
NPI:1861423071
Name:CHAMBERLAIN, DAVID P (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:CHAMBERLAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W MERCURY ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1652
Mailing Address - Country:US
Mailing Address - Phone:406-723-1300
Mailing Address - Fax:406-723-1360
Practice Address - Street 1:300 W MERCURY ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1652
Practice Address - Country:US
Practice Address - Phone:406-723-1300
Practice Address - Fax:406-723-1360
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9601207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT27937OtherBCBS
MT81740Medicare ID - Type UnspecifiedMEDICARE
MTH27420Medicare UPIN
MT27937Medicaid