Provider Demographics
NPI:1255792321
Name:FIEWEGER-DONCH, MARIANNE (LM, CLC)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:FIEWEGER-DONCH
Suffix:
Gender:F
Credentials:LM, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 CREST DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-9317
Mailing Address - Country:US
Mailing Address - Phone:406-570-4359
Mailing Address - Fax:406-582-1272
Practice Address - Street 1:435 CREST DR
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-9317
Practice Address - Country:US
Practice Address - Phone:406-570-4359
Practice Address - Fax:406-582-1272
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTAHC-MID-LIC-1295176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife