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General NPI Number Information
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NPI Number | 1740055466
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Entity Type | Organization
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Legal Business Name | MONTROSE REGIONAL GASTROENTEROLOGY
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Dates
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Enumeration Date | 11/22/2023
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 630 E STAR CT
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City | MONTROSE
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State | CO
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Zip | 81401-6702
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Country | US
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Telephone | 970-252-1020
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Fax | 970-252-1041
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Provider Business Mailing Address
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Address Line | 800 S 3RD ST
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City | MONTROSE
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State | CO
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Zip | 81401-4212
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Country | US
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Telephone | 970-240-2211
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Fax |
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Authorized Official
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Title or Position | ANAYLST
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Name | MEGAN BEAVER
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Credential |
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Telephone | 970-252-2691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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