Provider Demographics
NPI:1043205701
Name:MONTGOMERY, MARGARET L (CNM)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:L
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 IRVING ST NW
Mailing Address - Street 2:SUITE 4700 NORTH
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:202-877-7479
Mailing Address - Fax:202-877-7414
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:SUITE 4700 NORTH
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:202-877-7479
Practice Address - Fax:202-877-7414
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1016301176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA008765210001Medicaid
PA191610OtherHIGHMARK BLUE SHIELD
PA211879OtherUPMC
PA211879OtherUPMC
PA008765210001Medicaid
DC167407ZACMedicare PIN