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General NPI Number Information
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NPI Number | 1588782056
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Entity Type | Individual
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Provider Name | MONICA MONTEMAYOR M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 4200 WHITEHALL DR SUITE 230
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City | ANN ARBOR
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State | MI
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Zip | 48105-9694
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Country | US
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Telephone | 734-769-3896
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Fax | 734-769-3746
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Provider Business Mailing Address
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Address Line | 24 FRANK LLOYD WRIGHT DR PO BOX 0446 LOBBY J
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City | YPSILANTI
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State | MI
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Zip | 48106-0446
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Country | US
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Telephone | 734-747-6766
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Fax | 734-222-3100
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301085971
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License Number State | MI
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