Provider Demographics
NPI:1386868628
Name:MONTGOMERY ORIENTAL MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:MONTGOMERY ORIENTAL MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:301-947-0369
Mailing Address - Street 1:12904 DARNESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3518
Mailing Address - Country:US
Mailing Address - Phone:301-947-0369
Mailing Address - Fax:240-597-6232
Practice Address - Street 1:12904 DARNESTOWN RD
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-3518
Practice Address - Country:US
Practice Address - Phone:301-947-0369
Practice Address - Fax:240-597-6232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00865171100000X
DCNAT249175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty