Provider Demographics
NPI:1679767453
Name:MONTES, ANNE CAMILLE ALTEZ (MD)
Entity type:Individual
Prefix:
First Name:ANNE CAMILLE
Middle Name:ALTEZ
Last Name:MONTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 DORIC AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-2903
Mailing Address - Country:US
Mailing Address - Phone:401-467-9610
Mailing Address - Fax:401-467-9030
Practice Address - Street 1:1090 CRANSTON ST
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-7323
Practice Address - Country:US
Practice Address - Phone:401-943-1981
Practice Address - Fax:401-943-2896
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT188960207Q00000X
RIMD13042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine