Individual
DR. LORIE A. MONTAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1212 PLEASANT, SUITE #LL3, DES MOINES, IA 50309-1414
(515) 241-8861
(515) 241-8855
Mailing address
PO BOX 744327, ATLANTA, GA 30374-4327
(515) 241-8861
(515) 241-8855
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
102401
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001057500
COMMUNITY HEALTH PLAN
—
05
—
100324250A
—
KS
05
—
203860804
—
MO
01
—
25321019
BLUE CROSS BLUE SHIELD KC
—
Enumeration date
06/23/2006
Last updated
07/05/2021
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