Individual
MR. ALEXANDER HEALY MONTAVON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA-C
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
67.000236
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
67.000236
OHIO MEDICAL LICENSE
OH
Enumeration date
07/16/2014
Last updated
07/16/2014
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