Individual
DR. ANTHONY MONTELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
15324 E 10 MILE RD, EASTPOINTE, MI 48021-1012
(586) 777-9100
(586) 777-9100
Mailing address
15324 E 10 MILE RD, EASTPOINTE, MI 48021-1012
(586) 777-9100
(586) 777-9100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002464
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156260001
DME MEDICARE
—
05
—
5089743
—
MI
01
—
OE06847
BLUE CROSS OF MICH
—
Enumeration date
09/28/2006
Last updated
03/17/2013
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