Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 0024171833 | VA |
NPI | 1174930705 |
---|---|
Provider Name | Emily Montaigne |
First Address | Ashland, VA 23005-7555 |
Second Address | Glen Allen, VA 23059-5802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2014 |
Last Update Date | 15/07/2014 |