Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 18722 | MT |
NPI | 1194927293 |
---|---|
Provider Name | Dr. Summer Elizabeth Monforte |
First Address | Clancy, MT 59634 |
Second Address | Helena, MT 59601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 12/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
48980820 | (05) | CO |
FM2191601 | DEA (01) | CO |