Individual
WILLIAM MONTAGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8701 W WATERTOWN PLANK RD, WAUWATOSA, WI 53226-3548
(414) 955-8296
Mailing address
1701 W CHARLESTON BLVD, STE 490, LAS VEGAS, NV 89102-2309
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
LL3665
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7646766
DIVER'S LICENSE
OR
Enumeration date
03/23/2020
Last updated
06/29/2021
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