Provider Demographics
NPI:1154657039
Name:INTERNAL MEDICINE ASOCIATES OF MONTGOMERY VILLAGE
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASOCIATES OF MONTGOMERY VILLAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BALNATH
Authorized Official - Middle Name:
Authorized Official - Last Name:BHANDARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-330-2700
Mailing Address - Street 1:18550 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-0586
Mailing Address - Country:US
Mailing Address - Phone:301-330-2700
Mailing Address - Fax:301-990-7170
Practice Address - Street 1:18550 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-0586
Practice Address - Country:US
Practice Address - Phone:301-330-2700
Practice Address - Fax:301-990-7170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty