Individual
MRS. EMMA P MONTANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4275 BURNHAM AVE STE 340, LAS VEGAS, NV 89119-5400
(702) 734-6363
(702) 734-6374
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24841
NV
207R00000X
Internal Medicine Physician
D0079620
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03029353
AMERICAID
MD
05
—
1164414298
—
NV
01
—
1225902
USA
MD
01
—
24841
STATE LICENSE
NV
01
—
305127
JOHNS HOPKINS EHP
MD
01
—
3741957
CIGNA/GREAT WEST/BRAVO/ELDERHEALTH
MD
01
—
524002
AETNA/PRUDENTIAL HMO
MD
01
—
7449511
AETNA/PRUDENTIAL NON-HMO
MD
05
—
854003800
—
MD
01
—
BV89-0001
CAREFIRST/BC-BS
MD
Enumeration date
08/16/2005
Last updated
03/04/2024
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