Healthcare Provider Details

I. General information

NPI: 1275740706
Provider Name (Legal Business Name): JOSEPH ROBERT MONTANTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4740 TABLE MESA DR SUITE C
BOULDER CO
80305-4505
US

IV. Provider business mailing address

4740 TABLE MESA DR SUITE C
BOULDER CO
80305-4505
US

V. Phone/Fax

Practice location:
  • Phone: 720-304-6539
  • Fax: 720-304-6527
Mailing address:
  • Phone: 720-304-6539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22290
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number22290
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: