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Individual

DR. MIGDONIA MONTEJO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
110 KINGSLEY LN, SUITE 106, NORFOLK, VA 23505-4614
(757) 889-5735
(757) 889-5742
Mailing address
110 KINGSLEY LN, SUITE 106, NORFOLK, VA 23505-4614
(757) 889-5735
(757) 889-5742

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101058505
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
119124
ANTHEM BC/BS
VA
01
19462
SENTARA OPTIMA
VA
01
370927
MDIPA/MAMSI/OPTIMUM
05
5602076
VA
01
603296
BC/BS PENNSYLVANIA
PA
01
7852026
AETNA
05
89064GW
NC
Enumeration date
07/07/2005
Last updated
12/18/2007
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