Healthcare Provider Details

I. General information

NPI: 1154407617
Provider Name (Legal Business Name): STEVEN J MONTANTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 08/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5706 GROVE AVE STE 201
RICHMOND VA
23226
US

IV. Provider business mailing address

5706 GROVE AVE STE 201
RICHMOND VA
23226-2343
US

V. Phone/Fax

Practice location:
  • Phone: 804-325-4795
  • Fax: 804-441-8746
Mailing address:
  • Phone: 804-325-4795
  • Fax: 804-441-8746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number0101055334
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35096601
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: