Provider Demographics
NPI:1861482523
Name:MONTES, ISMAEL GARCIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ISMAEL
Middle Name:GARCIA
Last Name:MONTES
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 1:37 COVE DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-9579
Mailing Address - Country:US
Mailing Address - Phone:912-961-1257
Mailing Address - Fax:
Practice Address - Street 1:37 COVE DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-9579
Practice Address - Country:US
Practice Address - Phone:912-961-1257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA014843207P00000X
VA0101019618207P00000X
PAMD042932E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000012581NMedicaid
GAP01004099OtherRAILROAD MEDICARE
GAP01105616OtherRAILROAD MEDICARE
GA000012581QMedicaid
GA000012581OMedicaid
GA000012581PMedicaid
GA000012581QMedicaid
GA000012581NMedicaid
GA202I930776Medicare PIN