MEDICARE: DR. CHRISTIAN MONTAGANO DO

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	207P00000X	Emergency Medicine Physician	200501214	NC
2	207P00000X	Emergency Medicine Physician	1217	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1408G	OTHER	NC	BCBS GROUP # 015CK

General Provider Information

NPI Number	:	1780685040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIAN MONTAGANO DO

Provider Business Mailing Address
First Line	:	2498 N PLEASANTBURG DR
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29609-2730
Country	:	US
Telephone Number	:	864-305-5000
Fax Number	:	864-840-8207

Provider Business Practice Location Address
First Line	:	2498 N PLEASANTBURG DR
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29609-2730
Country	:	US
Telephone Number	:	864-305-5000
Fax Number	:	864-840-8207

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	04/17/2025

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