Provider Demographics
NPI:1164715827
Name:MONACO, NATHAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:A
Last Name:MONACO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 EMBASSY PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-8400
Mailing Address - Country:US
Mailing Address - Phone:330-668-4040
Mailing Address - Fax:
Practice Address - Street 1:3925 EMBASSY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-8400
Practice Address - Country:US
Practice Address - Phone:330-668-4055
Practice Address - Fax:330-668-4077
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35128803207X00000X
OH35.128803207XS0106X
PAMT199971390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program