Organization
COPPER CITY RADIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HASSAN MASSOUH MD (OWNER)
(406) 461-2953
Entity
Organization
Contact information
Practice address
400 S CLARK ST, BUTTE, MT 59701-2328
(406) 723-2658
(406) 723-2624
Mailing address
PO BOX 1160, HELENA, MT 59624-1160
(406) 723-2658
(406) 723-2624
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
10582
MT
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0085442
—
MT
01
—
98815
BLUE CROSS/BLUE SHIELD
MT
Enumeration date
06/01/2017
Last updated
07/21/2022
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