MEDICARE: LAURIE MONTANO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	4970	AK

General Provider Information

NPI Number	:	1710958061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE MONTANO M.D.

Provider Business Mailing Address
First Line	:	4048 LAUREL ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5391
Country	:	US
Telephone Number	:	907-770-7800
Fax Number	:	907-929-4660

Provider Business Practice Location Address
First Line	:	4048 LAUREL ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5333
Country	:	US
Telephone Number	:	907-770-7800
Fax Number	:	907-929-4660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	02/24/2010

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Directions to “ LAURIE MONTANO M.D.” Practice Location

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