Provider Demographics
NPI:1154592384
Name:MONTOYA, MARIO IGNACIO (MD)
Entity type:Individual
Prefix:
First Name:MARIO
Middle Name:IGNACIO
Last Name:MONTOYA
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 1:1848 SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1709
Mailing Address - Country:US
Mailing Address - Phone:412-478-2083
Mailing Address - Fax:
Practice Address - Street 1:SCAIFE HALL SUITE A-1305
Practice Address - Street 2:3550 TERRACE STREET
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-0001
Practice Address - Country:US
Practice Address - Phone:412-647-2994
Practice Address - Fax:412-647-2993
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-16
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432940207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology