Provider Demographics
NPI:1114932076
Name:MOMANY, GEORGE MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:MARSHALL
Last Name:MOMANY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 N LIDGERWOOD ST STE 218
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-1122
Mailing Address - Country:US
Mailing Address - Phone:509-723-7999
Mailing Address - Fax:877-670-2123
Practice Address - Street 1:5901 N LIDGERWOOD ST STE 218
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1122
Practice Address - Country:US
Practice Address - Phone:509-723-7999
Practice Address - Fax:877-670-2123
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA27010207L00000X
WAMD00027010207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8308843Medicaid
000355523Medicare PIN
WA8308843Medicaid
E72453Medicare UPIN