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NPI Code Detail

MEDICARE: ERIN GREEN D.O.

MEDICARE: ERIN GREEN D.O.
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 PhysicianMED-PHYS-LIC-75647MT

General Provider Information

NPI Number : 1548618119
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN GREEN D.O.
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 :
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 :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2016
Last Update Date : 06/15/2026

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