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Individual
EDWARD P MONTANEZ
Active
Individual
EDWARD P MONTANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17355
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0949099
MEDIPASS
IA
01
—
1366415721
NPI
—
01
—
17355
LICENSE
NE
05
—
470710146-13
—
NE
Enumeration date
02/08/2006
Last updated
03/07/2023
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