Provider Demographics
NPI:1043672942
Name:DONG, ANNIE C (MD, MPH)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:C
Last Name:DONG
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2827 FORT MISSOULA RD BLDG 5
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-7408
Mailing Address - Country:US
Mailing Address - Phone:406-327-4646
Mailing Address - Fax:406-327-4649
Practice Address - Street 1:2827 FORT MISSOULA RD BLDG 5
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-7408
Practice Address - Country:US
Practice Address - Phone:406-327-4646
Practice Address - Fax:406-327-4649
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME155656207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology