Provider Demographics
NPI:1396399382
Name:RAPAPORT, GARY MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:MICHAEL
Last Name:RAPAPORT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-2728
Mailing Address - Country:US
Mailing Address - Phone:406-431-7359
Mailing Address - Fax:
Practice Address - Street 1:720 MADISON AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-2728
Practice Address - Country:US
Practice Address - Phone:406-431-7359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-28
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT70502083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine