Provider Demographics
NPI:1679588537
Name:WHITESELL, ALBERT L (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:L
Last Name:WHITESELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1101 26TH ST S
Mailing Address - Street 2:BMG ADMIN
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405
Mailing Address - Country:US
Mailing Address - Phone:406-455-5000
Mailing Address - Fax:406-731-8318
Practice Address - Street 1:1101 26TH ST S
Practice Address - Street 2:BMG ADMIN
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405
Practice Address - Country:US
Practice Address - Phone:406-455-5000
Practice Address - Fax:406-731-8318
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO45728207L00000X
MT104236207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COE69420Medicare UPIN
NM344509411Medicare ID - Type UnspecifiedMEDICARE