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Contact Information

EDWIN MEDINA, MD
830 S CENTRAL AVE
MALTA, MT59538
 Phone: 406-390-2596
 Fax: 406-654-2571
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for EDWIN MEDINA · (Male)

NPI Number 1356487201
Status Active
Credentials MD
Entity Individual
Enumeration date 01/29/2007
Last updated 01/18/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • MT License # 9635
  • MT Medicaid 0028223
  • MT Medicaid 0720001
  • MT Other 000092611 BLUE CROSS BLUE SHIELD
Hospital affiliation(s)
  • PHILLIPS COUNTY MEDICAL CENTER - (Critical Access)
    311 S 8TH AVE E
    MALTA, MT 59538
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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