Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 0101059160 | VA |
NPI | 1306848270 |
---|---|
Provider Name | Thomas W Montag |
First Address | Chesapeake, VA 23320-4945 |
Second Address | Chesapeake, VA 23320-4945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 16/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00X210T01 | MEDICARE (01) | VA |
1075087 | MAMSI (GYN) (01) | |
1175087 | MAMSI (ONC) (01) | |
1231740 | FIRST HEALTH (01) | |
21941 | SENTARA (01) | |
2998639 | CIGNA (01) | |
3600719 | UNITED HEALTHCARE (01) | |
4232842 | AETNA (01) | |
463796 | ANTHEM (01) | |
621780-0 | (05) | VA |
D24867 | (02) | |
P00065884 | RAILROAD MEDICARE (01) |