Individual
TREVE MICHAEL ICENOGGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 WESTWOOD DR STE I, HAMILTON, MT 59840-2345
(406) 363-1100
(406) 375-4884
Mailing address
1224 W MAIN ST, HAMILTON, MT 59840-2338
(406) 363-2211
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MED-PHYS-LIC-163863
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200036236
—
MT
Enumeration date
03/24/2021
Last updated
01/05/2026
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