Individual
JAIME H MONTOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 N MAIN ST, GREENVILLE, PA 16125-1726
(724) 588-6366
Mailing address
PO BOX 73985, CLEVELAND, OH 44193-0002
(866) 338-6467
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD037036L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000368853
BC BS
OH
05
—
1013434960001
—
PA
05
—
2609430
—
OH
Enumeration date
02/13/2006
Last updated
07/18/2007
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