Provider Demographics
NPI:1023171717
Name:GIANARELLI, TODD E (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:E
Last Name:GIANARELLI
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 1:317 5TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:CONRAD
Mailing Address - State:MT
Mailing Address - Zip Code:59425-2506
Mailing Address - Country:US
Mailing Address - Phone:406-278-3596
Mailing Address - Fax:
Practice Address - Street 1:670 PARK AVE
Practice Address - Street 2:MARIAS HEALTHCARE SERVICES INC
Practice Address - City:SHELBY
Practice Address - State:MT
Practice Address - Zip Code:59474-1663
Practice Address - Country:US
Practice Address - Phone:406-434-3100
Practice Address - Fax:406-434-3143
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8416207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT2210052Medicaid
MT2210052Medicaid
MTG30908Medicare UPIN