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NPI Code Detail

MEDICARE: ARMANDO MONTANA PA

MEDICARE: ARMANDO MONTANA PA
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
1363A00000XPhysician Assistant002791GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992791552
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARMANDO MONTANA PA
Provider Business Mailing Address
First Line : 221 TECHNOLOGY PKWY NW
Second Line :
City : ROME
State : GA
Zip : 30165-1369
Country : US
Telephone Number : 762-235-1000
Fax Number :
Provider Business Practice Location Address
First Line : 150 GENTILLY BLVD
Second Line :
City : CARTERSVILLE
State : GA
Zip : 30120-8522
Country : US
Telephone Number : 470-490-7470
Fax Number : 770-386-7910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 04/28/2020

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Directions to “ ARMANDO MONTANA PA” Practice Location

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