# MONTAGUE BLUNDON, III, MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114223617
- **Authorized official:** MONTAGUE BLUNDON III M.D. (OWNER)
- **Authorized official phone:** (301) 897-5505

## Contact information

- **Practice address:** 5640 SHIELDS DR, WYNGATE MEDICAL PARK, BETHESDA, MD 20817-3573
- **Practice address phone:** (307) 897-5505
- **Practice address fax:** (301) 897-0887
- **Mailing address:** 5640 SHIELDS DR, WYNGATE MEDICAL PARK, BETHESDA, MD 20817-3573
- **Mailing address phone:** (301) 897-5505
- **Mailing address fax:** (301) 897-0887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | D0025637 | MD | Yes |

## Other

- **Enumeration date:** 01/31/2011
- **Last updated:** 02/15/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 266081400 | — | MD |