Individual
MARLON JOSE MONTENEGRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
2125 STATE ST STE 6, NEW ALBANY, IN 47150-4972
(812) 948-7417
Mailing address
8338 WABASH AVE, TERRE HAUTE, IN 47803-3982
(138) 630-2394
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
20-391
WI
208600000X
Surgery Physician
Primary
20-931
WI
Other
Enumeration date
02/25/2022
Last updated
02/25/2022
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