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NPI Code Detail

MEDICARE: TERESA AUGUSTINE M.D.

MEDICARE: TERESA AUGUSTINE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician10688MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497721013
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA AUGUSTINE M.D.
Provider Business Mailing Address
First Line : 1122 N MONTANA AVE
Second Line :
City : HELENA
State : MT
Zip : 59601-3513
Country : US
Telephone Number : 406-449-5563
Fax Number : 406-449-4730
Provider Business Practice Location Address
First Line : 1122 N MONTANA AVE
Second Line :
City : HELENA
State : MT
Zip : 59601-3513
Country : US
Telephone Number : 406-449-5563
Fax Number : 406-449-4730
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2006
Last Update Date : 09/13/2019

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Directions to “ TERESA AUGUSTINE M.D.” Practice Location

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