Provider Demographics
NPI:1982670980
Name:MONTEMARANO, ANDREW DENIS (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DENIS
Last Name:MONTEMARANO
Suffix:
Gender:M
Credentials:DO
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6410 ROCKLEDGE DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-7811
Mailing Address - Country:US
Mailing Address - Phone:301-564-3131
Mailing Address - Fax:301-564-6391
Practice Address - Street 1:6410 ROCKLEDGE DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7811
Practice Address - Country:US
Practice Address - Phone:301-564-3131
Practice Address - Fax:301-564-6391
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102049859207ND0101X
MDH0050943207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G00412-006979S12Medicare ID - Type Unspecified
G61566Medicare UPIN