Provider Demographics
NPI:1760060412
Name:ENGSTROM, PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:ENGSTROM
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N OAK ST
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:MT
Mailing Address - Zip Code:59644-2306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:877-796-4457
Practice Address - Street 1:110 N OAK ST
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:MT
Practice Address - Zip Code:59644-2306
Practice Address - Country:US
Practice Address - Phone:406-237-5200
Practice Address - Fax:877-796-4457
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT141717207Q00000X, 207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program