Individual
AMANDA MONTALBANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20300 E VALLEY VIEW PKWY, CHILDREN'S MERCY HOSPITAL, INDEPENDENCE, MO 64057-1672
(816) 478-5252
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
04-36395
KS
208000000X
Pediatrics Physician
Primary
2013010101
MO
Other
Enumeration date
06/28/2010
Last updated
01/30/2020
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