MEDICARE: MONTGOMERY MEDICAL SERVICES, PLLC

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
1	363LF0000X	Family Nurse Practitioner	3004221	KY
2	207RH0003X	Hematology & Oncology Physician	37117	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1568431443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTGOMERY MEDICAL SERVICES, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 704
Second Line	:
City	:	MT STERLING
State	:	KY
Zip	:	40353-0704
Country	:	US
Telephone Number	:	859-499-1000
Fax Number	:	859-499-4181

Provider Business Practice Location Address
First Line	:	644 MAYSVILLE RD
Second Line	:	SUITE 10
City	:	MT STERLING
State	:	KY
Zip	:	40353-9464
Country	:	US
Telephone Number	:	859-499-1000
Fax Number	:	859-499-4181

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	MUHAMMAD-ALI AKRAM ZAYDAN
Credential	:	MD
Telephone Number	:	859-499-1000

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	06/23/2016

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Directions to “MONTGOMERY MEDICAL SERVICES, PLLC ” Practice Location

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