Individual
THOMAS W MONTAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
109 WIMBLEDON SQ, SUITE F, CHESAPEAKE, VA 23320-4945
(757) 436-9898
(757) 436-5455
Mailing address
109 WIMBLEDON SQ, SUITE F, CHESAPEAKE, VA 23320-4945
(757) 436-9898
(757) 436-5455
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
0101059160
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00X210T01
MEDICARE
VA
01
—
1075087
MAMSI (GYN)
—
01
—
1175087
MAMSI (ONC)
—
01
—
1231740
FIRST HEALTH
—
01
—
21941
SENTARA
—
01
—
2998639
CIGNA
—
01
—
3600719
UNITED HEALTHCARE
—
01
—
4232842
AETNA
—
01
—
463796
ANTHEM
—
05
—
621780-0
—
VA
01
—
P00065884
RAILROAD MEDICARE
—
Enumeration date
08/11/2005
Last updated
10/16/2007
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