Individual
DR. RAUL RODRIGUEZ MONTIAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301091372
MI
207LP2900X
Pain Medicine (Anesthesiology) Physician
34832
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-0-41-1822-1
BCBS PIN
MI
05
—
1284133
—
IA
01
—
M38730025
MEDICARE PART B
MI
01
—
RM091372
BCBS
MI
Enumeration date
03/14/2007
Last updated
07/03/2014
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