Provider Demographics
NPI:1134362155
Name:MONTANARO, MARC T (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:T
Last Name:MONTANARO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:933 BRADBURY DR SE STE 2222
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4375
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:933 BRADBURY DR SE STE 2222
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4375
Practice Address - Country:US
Practice Address - Phone:505-272-6225
Practice Address - Fax:505-272-5184
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2013-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2012-0024207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine