Provider Demographics
NPI:1669544631
Name:MONTEIRO, MICHAEL RICHARD SR (CP)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:RICHARD
Last Name:MONTEIRO
Suffix:SR
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6001 RED SETTER LN
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-2233
Mailing Address - Country:US
Mailing Address - Phone:804-370-6296
Mailing Address - Fax:
Practice Address - Street 1:2034 DABNEY RD
Practice Address - Street 2:SUITE C
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3361
Practice Address - Country:US
Practice Address - Phone:804-649-9043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist