| Mary Louise Vader, DO | |
|
947 So 5th St, Montrose, CO 81401-5716 | |
| (970) 249-2421 | |
| (970) 249-8897 |
| Full Name | Mary Louise Vader |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 947 So 5th St, Montrose, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568454106 | NPI | - | NPPES |
| 51283361 | Medicaid | CO | |
| 01304310 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 30431 (Colorado) | Primary |
| Entity Name | Montrose Hormone Health & Wellness Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003621186 PECOS PAC ID: 3375063761 Enrollment ID: O20250228002483 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Louise Vader, DO 947 So 5th St, Montrose, CO 81401-5716 Ph: (970) 249-2421 | Mary Louise Vader, DO 947 So 5th St, Montrose, CO 81401-5716 Ph: (970) 249-2421 |
Romeo Gonzaga Icasiano, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 947 So 5th St, Montrose, CO 81401 Phone: 870-249-2421 Fax: 970-249-8897 | |
Dr. Andrew Stephen Astin, DO Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 1010 S Rio Grande Ave, Montrose, CO 81401 Phone: 970-497-3333 Fax: 855-299-7837 | |
Thomas C Miller, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 947 S 5th St, Montrose, CO 81401 Phone: 970-249-2421 Fax: 970-249-8897 | |
Libuse K Engelbach, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 947 So 5th St, Montrose, CO 81401 Phone: 970-249-2421 Fax: 970-249-8897 | |
Gregory Paul Suchon, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 947 So Fifth St, Montrose, CO 81401 Phone: 970-249-2421 Fax: 970-249-8897 | |
Brenna Marie Cameron, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 947 S 5th St, Montrose, CO 81401 Phone: 970-249-2421 |