Individual
MARK LETTERIO MONTEFERRANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3301 NEW MEXICO AVE NW, SUITE 106, WASHINGTON, DC 20016-3622
(202) 966-0606
(202) 244-6757
Mailing address
3201 JERMANTOWN RD STE 550, FAIRFAX, VA 22030-2885
(703) 667-8600
(703) 667-8601
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
185036
NY
2085R0202X
Diagnostic Radiology Physician
D0044877
MD
2085R0202X
Diagnostic Radiology Physician
Primary
MD20122
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161631501
—
MD
01
—
300135377
RR MEDICARE
—
01
—
470001526
RR MEDICARE
—
Enumeration date
11/07/2005
Last updated
06/21/2021
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