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General NPI Number Information
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NPI Number | 1285640235
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Entity Type | Individual
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Provider Name | MATTHEW C MONTEIRO MD
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 04/15/2019
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Provider Practice Location Address
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Address Line | 404 HIGHWAY 96 W
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City | SHOREVIEW
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State | MN
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Zip | 55126-1900
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Country | US
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Telephone | 651-483-8283
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Fax | 651-483-8299
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Provider Business Mailing Address
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Address Line | 2025 SLOAN PL STE 35
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City | SAINT PAUL
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State | MN
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Zip | 55117-2092
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Country | US
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Telephone | 651-772-1572
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Fax | 651-772-1889
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 45801
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License Number State | MN
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