Provider Demographics
NPI:1013961119
Name:MOUNTIS, MARIA M (DO)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:M
Last Name:MOUNTIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7740B STENTON AVE
Mailing Address - Street 2:APT. 304
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-3169
Mailing Address - Country:US
Mailing Address - Phone:215-242-0748
Mailing Address - Fax:
Practice Address - Street 1:7740B STENTON AVE
Practice Address - Street 2:APT. 304
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3169
Practice Address - Country:US
Practice Address - Phone:215-242-0748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012280207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease