Individual
EMMETT FULCHER MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 KNOX CT STE 100, DAVIDSON, NC 28036-0590
(704) 892-5454
(704) 892-5858
Mailing address
PO BOX 4329, DAVIDSON, NC 28036-4329
(704) 892-5454
(704) 892-5858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35242
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8960083
—
NC
Enumeration date
09/22/2005
Last updated
12/20/2022
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