Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 25MA06243600 | NJ |
NPI | 1124108808 |
---|---|
Provider Name | Dr. David H Montgomery |
First Address | Oakland, NJ 07436 |
Second Address | Oakland, NJ 07436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 29/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
182669 | (02) | |
8614202 | (05) | NJ |
G19663 | (02) |