# PIONEER PEAK ORTHOPEDICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548639727
- **Authorized official:** MICHAEL MONTANO M.D. (PHYSICIAN AND 1/3 OWNER)
- **Authorized official phone:** (907) 707-1671

## Contact information

- **Practice address:** 3765 E. BLUE LUPINE DR. SUITE D, WASILLA, AK 99654
- **Practice address phone:** (907) 707-1671
- **Mailing address:** 3765 E. BLUE LUPINE DR. SUITE D, WASILLA, AK 99654
- **Mailing address phone:** (907) 707-1671

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/17/2015
- **Last updated:** 10/05/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1635143 | — | AK |