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NPI Code Detail

MEDICARE: MONTGOMERY RENAL ASSOCIATES P.A.

MEDICARE: MONTGOMERY RENAL ASSOCIATES P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558316752
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONTGOMERY RENAL ASSOCIATES P.A.
Provider Business Mailing Address
First Line : 3941 FERRARA DR
Second Line :
City : WHEATON
State : MD
Zip : 20906-4709
Country : US
Telephone Number : 301-942-5355
Fax Number :
Provider Business Practice Location Address
First Line : 3941 FERRARA DR
Second Line :
City : WHEATON
State : MD
Zip : 20906-4709
Country : US
Telephone Number : 301-942-5355
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. BARRY I HECHT
Credential : M.D.
Telephone Number : 301-942-5355
Provider Enumeration Date : 05/24/2006
Last Update Date : 09/14/2018

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