Provider Demographics
NPI:1548203219
Name:MONTEIRO, JOSE A L (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:A L
Last Name:MONTEIRO
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 1:211 MILLIKEN BLVD
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721
Mailing Address - Country:US
Mailing Address - Phone:508-674-5200
Mailing Address - Fax:508-675-1719
Practice Address - Street 1:211 MILLIKEN BLVD
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721
Practice Address - Country:US
Practice Address - Phone:508-674-5200
Practice Address - Fax:508-675-1719
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2015-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74949207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9784888Medicaid
F97378Medicare UPIN
MA9784888Medicaid