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Organization

MONTGOMERY INTERNAL MEDICINE ASSOC., P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JONATHAN MALTZ M.D. (PRESIDENT)
(301) 774-6655
Entity
Organization

Contact information

Practice address
2901 OLNEY SANDY SPRING RD, OLNEY, MD 20832-1521
(301) 774-6655
(301) 774-5652
Mailing address
2901 OLNEY SANDY SPRING RD, OLNEY, MD 20832-1521
(301) 774-6655
(301) 774-5652

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RG0100X
Gastroenterology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9112715
MD
Enumeration date
07/05/2006
Last updated
04/07/2010
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