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General NPI Number Information
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NPI Number | 1578592275
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Entity Type | Individual
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Provider Name | JULIA LYNN MONTEJO M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 11104 PARKVIEW CIRCLE DR STE 10
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City | FORT WAYNE
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State | IN
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Zip | 46845-1733
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Country | US
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Telephone | 260-425-6070
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Fax | 260-425-6073
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Provider Business Mailing Address
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Address Line | 11109 PARKVIEW PLAZA DR # 117
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City | FORT WAYNE
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State | IN
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Zip | 46845-1701
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Country | US
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Telephone |
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Fax |
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 46049
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 01097106A
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License Number State | IN
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