Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marlon Jose Montenegro, CSFA

Individual provider Surgery Physician · NPI 1588310734

Marlon Jose Montenegro, CSFA is a Surgery Physician in New Albany, Indiana. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2022
Specialties on file
2

Practice location Address checks out

2125 State St Ste 6
New Albany, IN 47150-4972
Phone: (812) 948-7417
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 20-931 (WI)
Surgery Physician Taxonomy 208600000X · Licence 20-391 (WI)

Record details

NPI number1588310734
Entity typeIndividual (Type 1)
GenderMale
Credentials CSFA
Sole proprietorYes
NPI enumeratedFebruary 25, 2022
Last updated in NPPESFebruary 25, 2022
Certification dateFebruary 25, 2022

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