Healthcare Provider Details

I. General information

NPI: 1679516751
Provider Name (Legal Business Name): MICHAEL A MONT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BELVEDERE AVE FL 5
BALTIMORE MD
21215-5216
US

IV. Provider business mailing address

2401 W BELVEDERE AVE FL 5
BALTIMORE MD
21215-5216
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-8500
  • Fax: 410-601-8501
Mailing address:
  • Phone: 410-601-8500
  • Fax: 410-601-8501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number35.129335
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberD40090
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: