Provider Demographics
NPI:1689678427
Name:MONTGOMERY, MARGARET THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:THOMAS
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 STONY POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1979
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9105 STONY POINT PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1979
Practice Address - Country:US
Practice Address - Phone:804-287-1030
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABM1215385207L00000X
VA0101041610207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1465702OtherCIGNA
VA3986241OtherAETNA HMO
VA4364849OtherAETNA PPO
VA42902OtherSOUTHERN HEALTH
VA2137659OtherALLIANCE
VA2000145OtherUNITED HEALTHCARE
VA56657OtherCARNET SHS
VA97045OtherSENTARA FAMILY CARE
VA97045OtherSENTARA FAMILY CARE
VAE45964Medicare UPIN