Provider Demographics
NPI:1700981529
Name:HACHIGIAN-GOULD, AIMEE VARTENY (MD)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:VARTENY
Last Name:HACHIGIAN-GOULD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 15TH AVE S
Mailing Address - Street 2:STE G12
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4324
Mailing Address - Country:US
Mailing Address - Phone:406-731-8080
Mailing Address - Fax:406-731-8084
Practice Address - Street 1:500 15TH AVE S
Practice Address - Street 2:STE G12
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4324
Practice Address - Country:US
Practice Address - Phone:406-731-8080
Practice Address - Fax:406-731-8084
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301044361207X00000X
CAG53605207X00000X
MT5176207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT87009Medicaid
D96302Medicare UPIN
MT000196001Medicare ID - Type Unspecified