Provider Demographics
NPI:1851629695
Name:MONTGOMERY HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:MONTGOMERY HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MIHAI
Authorized Official - Middle Name:G
Authorized Official - Last Name:SIRBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-452-4062
Mailing Address - Street 1:20724 SUMMER SWEET TER
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-3903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1776 POWDER MILL RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1514
Practice Address - Country:US
Practice Address - Phone:301-434-0599
Practice Address - Fax:301-434-0157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty