Most Relevant Information
Provider Data
| NPI Number: | 1003059338 |
| Provider Name: | MONTIA LORENZ GOLETTE-LEWIS PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | C0001966 |
Most Important Dates
| Enumeration Date: | 04/16/2009 |
| Last Updated: | 09/14/2012 |
Provider Practice Location
2209 DEFENSE HWY
SUITE C
CROFTON
MD
211142403
Practice Location Phone/Fax
| Phone: | 8888086483 |
| Fax: |
Provider Mailing Location
2209 DEFENSE HWY
SUITE C
CROFTON
MD
211142403
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |