Provider Demographics
NPI:1245268952
Name:MONTGOMERY ORTHOPAEDICS, P.A.
Entity type:Organization
Organization Name:MONTGOMERY ORTHOPAEDICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EFRAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-949-8100
Mailing Address - Street 1:8401 CONNECTICUT AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5803
Mailing Address - Country:US
Mailing Address - Phone:301-949-8100
Mailing Address - Fax:301-962-7450
Practice Address - Street 1:8401 CONNECTICUT AVE
Practice Address - Street 2:STE 800
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5803
Practice Address - Country:US
Practice Address - Phone:301-949-8100
Practice Address - Fax:301-962-7450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0426110002Medicare NSC