Individual
SHARI VANDYKE MONTANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
714 W APPLEWAY AVE STE 200, COEUR D ALENE, ID 83814-9330
(208) 665-1552
Mailing address
550 S JACKSON ST, ACB 3RD FLOOR, LOUISVILLE, KY 40202-1622
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
O0945
ID
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/31/2009
Last updated
12/28/2017
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