Healthcare Provider Details

I. General information

NPI: 1245236074
Provider Name (Legal Business Name): MICHAEL MONTOPOLI MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 37TH ST NW
WASHINGTON DC
20008-3132
US

IV. Provider business mailing address

4201 37TH ST NW
WASHINGTON DC
20008-3132
US

V. Phone/Fax

Practice location:
  • Phone: 202-966-2642
  • Fax:
Mailing address:
  • Phone: 202-966-2642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: