{
"Npi": {
"NPI": "1528145497",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MONTANTE",
"FirstName": "RAUL",
"MiddleName": "MALLARE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "48760 N TERRITORIAL RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLYMOUTH",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48170-2849",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "734-927-4414",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "25711 W WARREN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DEARBORN HEIGHTS",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48127-2046",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "313-274-2400",
"PracticeLocationAddressFaxNumber": "313-274-6459",
"EnumerationDate": "10/31/2006",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "4301061984",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}