Healthcare Provider Details

I. General information

NPI: 1679534267
Provider Name (Legal Business Name): MARIAN LAMONTE MD, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3407 WILKENS AVE STE 430
BALTIMORE MD
21229-5073
US

IV. Provider business mailing address

3407 WILKENS AVE STE 430
BALTIMORE MD
21229-5073
US

V. Phone/Fax

Practice location:
  • Phone: 667-234-8444
  • Fax: 667-234-8432
Mailing address:
  • Phone: 667-234-8444
  • Fax: 667-234-8432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberD0044420
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberD0044420
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberD0044420
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: