Healthcare Provider Details

I. General information

NPI: 1316964372
Provider Name (Legal Business Name): MONTE SOL MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 11/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SAINT MICHAELS DR
SANTA FE NM
87505-7601
US

IV. Provider business mailing address

5410 MARYLAND WAY SUITE 300
BRENTWOOD TN
37027-5064
US

V. Phone/Fax

Practice location:
  • Phone: 505-989-6130
  • Fax: 505-820-5408
Mailing address:
  • Phone: 615-377-5670
  • Fax: 615-377-1678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM PLAUTH
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 509-989-6130