Provider Demographics
NPI:1790851319
Name:PAUSTIAN, RICHARD DAVID (MD FACC FACP FSCAI F)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DAVID
Last Name:PAUSTIAN
Suffix:
Gender:M
Credentials:MD FACC FACP FSCAI F
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601
Mailing Address - Country:US
Mailing Address - Phone:406-449-7943
Mailing Address - Fax:406-449-2916
Practice Address - Street 1:32 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601
Practice Address - Country:US
Practice Address - Phone:406-449-7943
Practice Address - Fax:406-449-2916
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4841207RI0011X
GA019978207RI0011X
IN01027556A207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT71331Medicaid
MT1755Medicare ID - Type Unspecified
C64166Medicare UPIN