Healthcare Provider Details

I. General information

NPI: 1922622430
Provider Name (Legal Business Name): WILLIAM F MONAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2020
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35TH MEDICAL GROUP BUILDING 99, UNIT 5024
APO AP
96319-5024
US

IV. Provider business mailing address

35TH MEDICAL GROUP BUILDING 99, UNIT 5024
APO AP
96319-5024
US

V. Phone/Fax

Practice location:
  • Phone: 315-226-6647
  • Fax:
Mailing address:
  • Phone: 315-226-6647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34784
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: