Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 22290 | CO |
N | 207QA0505X | Family Doctor - Adult Medicine | 22290 | CO |
NPI | 1275740706 |
---|---|
Provider Name | Dr. Joseph Robert Montante |
First Address | Boulder, CO 80305-4505 |
Second Address | Boulder, CO 80305-4505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |