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General NPI Number Information
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NPI Number | 1265486898
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Entity Type | Individual
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Provider Name | DANIE TEJADO MONTANO PA
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | USA MEDDAC WUERZBURG CONN CTMC
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City | APO AE
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State | NY
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Zip | 09226-0000
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Country | US
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Telephone | 11-499-7219
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Fax |
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Provider Business Mailing Address
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Address Line | USA MEDDAC WUERZBURG ATTN: CREDENTIALS OFFICE, UNIT 26610
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City | APO
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State | AE
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Zip | 09224
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Country | US
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Telephone | 01149931804
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Fax | 3241
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | NCCPA 1051879
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License Number State |
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