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Individual

KYLE DAVID MONTGOMERY

Active
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Individual

KYLE DAVID MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD064400L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001822599
—
PA
01
—
028886
HIGHMARK BLUE SHIELD
PA
01
—
080164274
RAILROAD MEDICARE
PA
01
—
1458249
AETNA HMO
PA
01
—
2319021
AETNA HMO
PA
01
—
2Y7472
HEALTH NET
PA
01
—
30036753
KEYSTONE MERCY HEALTH PLA
PA
01
—
30036754
KEYSTONE MERCY HEALTH PLA
PA
01
—
497977
COVENTRY HEALTH AMERICA
PA
01
—
5466743
AETNA PPO
PA
01
—
6052
BRAVO HEALTH
PA
Enumeration date
12/15/2005
Last updated
01/13/2014
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