Physician Compare National (NPI:1477704021)

HEALTHCARE PROVIDER: ERIC R MONTGOMERY MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1477704021
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7416198833
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150107000286
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MONTGOMERY
	Individual professional last name
Provider First Name	ERIC
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	PATHOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	DELAWARE CLINICAL AND LABORATORY PHYSICIANS, PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	3476544214
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	14
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4701 OGLETOWN STANTON RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 4200
	Group Practice or individual's line 2 address
City	NEWARK
	Group Practice or individual's city
State	DE
	Group Practice or individual's state
Zip Code	197132075
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3027377700
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	390044
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	READING HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	080001
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHRISTIANA HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	390316
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SURGICAL INSTITUTE OF READING
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y