Provider Demographics
NPI:1871927277
Name:MONTES, ANDRES ISMAEL (MD)
Entity type:Individual
Prefix:MR
First Name:ANDRES
Middle Name:ISMAEL
Last Name:MONTES
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:ST.JOE CANDLER- MANAGED CARE DEPT
Mailing Address - Street 2:836 E. 65TH ST., BLDG 22
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405
Mailing Address - Country:US
Mailing Address - Phone:912-819-2622
Mailing Address - Fax:912-819-3320
Practice Address - Street 1:5354 REYNOLDS ST STE 422
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6011
Practice Address - Country:US
Practice Address - Phone:912-355-5593
Practice Address - Fax:912-355-5404
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
GA89593207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA89593OtherGEORGIA STATE BOARD