Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 248446 | MA |
Y | 207Q00000X | Family Doctor | MD046712 | DC |
NPI | 1003101973 |
---|---|
Provider Name | Dr. Ryan J. Montoya |
First Address | Washington, DC 20002-3431 |
Second Address | Washington, DC 20002-3431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2011 |
Last Update Date | 20/08/2019 |