MEDICARE: DR. MARK JAMES MONTANO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	38246	CO

General Provider Information

NPI Number	:	1225146731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK JAMES MONTANO M.D.

Provider Business Mailing Address
First Line	:	9330 S UNIVERSITY BLVD STE 100
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-5049
Country	:	US
Telephone Number	:	303-346-3627
Fax Number	:	303-683-9392

Provider Business Practice Location Address
First Line	:	9330 S UNIVERSITY BLVD STE 100
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-5049
Country	:	US
Telephone Number	:	303-346-3627
Fax Number	:	303-683-9392

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	06/15/2011

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