Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4301047332 | MI |
N | 207XS0117X | Orthopaedic Spine Surgeon | 4301047332 | MI |
NPI | 1013911510 |
---|---|
Provider Name | Dr. David M Montgomery |
First Address | Royal Oak, MI 48073-0980 |
Second Address | Royal Oak, MI 48073-0980 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 10/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4459527 | (05) | MI |
C58505 | (02) | MI |