MEDICARE: MARGARET THOMAS MONTGOMERY M.D.

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	207L00000X	Anesthesiology Physician	BM1215385	VA
2	207L00000X	Anesthesiology Physician	0101041610	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1465702	OTHER	VA	CIGNA
2	3986241	OTHER	VA	AETNA HMO
3	4364849	OTHER	VA	AETNA PPO
4	42902	OTHER	VA	SOUTHERN HEALTH
5	2137659	OTHER	VA	ALLIANCE
6	2000145	OTHER	VA	UNITED HEALTHCARE
7	56657	OTHER	VA	CARNET SHS
8	97045	OTHER	VA	SENTARA FAMILY CARE

General Provider Information

NPI Number	:	1689678427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET THOMAS MONTGOMERY M.D.

Provider Business Mailing Address
First Line	:	9105 STONY POINT PKWY
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-1979
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9105 STONY POINT PKWY
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-1979
Country	:	US
Telephone Number	:	804-287-1030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/09/2007

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