Provider Demographics
NPI:1396240131
Name:MONTEJO, JULIO DAMIAN JR (MD, MHS)
Entity type:Individual
Prefix:DR
First Name:JULIO
Middle Name:DAMIAN
Last Name:MONTEJO
Suffix:JR
Gender:M
Credentials:MD, MHS
Other - Prefix:DR
Other - First Name:JULIO
Other - Middle Name:DAMIAN
Other - Last Name:MONTEJO CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MHS
Mailing Address - Street 1:1 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-5748
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-5748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program