Provider Demographics
NPI:1720384431
Name:MONTGOMERY ANESTHESIA CARE, LLC
Entity Type:Organization
Organization Name:MONTGOMERY ANESTHESIA CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-922-9666
Mailing Address - Street 1:9420 KEY WEST AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3334
Mailing Address - Country:US
Mailing Address - Phone:301-922-9666
Mailing Address - Fax:301-309-0765
Practice Address - Street 1:15005 SHADY GROVE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6358
Practice Address - Country:US
Practice Address - Phone:301-340-8099
Practice Address - Fax:301-340-8535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-28
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty