Provider Demographics
NPI:1376053694
Name:MONTGOMERY, SARAH MICHELLE (DPM)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MICHELLE
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WEST ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2200
Mailing Address - Country:US
Mailing Address - Phone:508-473-2273
Mailing Address - Fax:508-473-2275
Practice Address - Street 1:160 WEST ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2200
Practice Address - Country:US
Practice Address - Phone:508-473-2273
Practice Address - Fax:508-473-2275
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006247213E00000X
MA2465213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist