Basic Information
Provider Information
NPI: 1275715310
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARCIA-MONTILLA
FirstName: ROMEL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 N OAK AVE
Address2:  
City: MARSHFIELD
State: WI
PostalCode: 544495703
CountryCode: US
TelephoneNumber: 7153875511
FaxNumber:  
Practice Location
Address1: 1000 N OAK AVE
Address2:  
City: MARSHFIELD
State: WI
PostalCode: 544495703
CountryCode: US
TelephoneNumber: 7153875511
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/30/2007
LastUpdateDate: 04/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD156703ORN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0200X51109-20WIY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


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