NPI 1235303801

Dominick Peter Trivisonno, MD

Practitioner General Practice Physician Baker, MT

Practice location

Address: 202 South 4th Street West, Baker, MT 59313-1119
Phone: (406) 778-2833
Fax: (406) 778-5131
Mailing address: PO Box 1119, Baker, MT 59313-1119

Registered specialties (2)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 173465 (NY)

Other General Practice providers in Montana →

General Practice Physician

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 11857 (MT)

Registry record

NPI: 1235303801
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Apr 2008
Record last updated: 30 Jan 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.