Provider Demographics
NPI:1942276977
Name:LAMONTAGNE, ARTHUR E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:E
Last Name:LAMONTAGNE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:116 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-5215
Mailing Address - Country:US
Mailing Address - Phone:860-643-2731
Mailing Address - Fax:860-643-6707
Practice Address - Street 1:116 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-5215
Practice Address - Country:US
Practice Address - Phone:860-643-2731
Practice Address - Fax:860-643-6707
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT17156208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4001350Medicaid
CT4001350Medicaid