Organization
MONTGOMERY SURGERY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WASHINGTON (VP)
(703) 650-2907
Entity
Organization
Contact information
Practice address
830 HOSPITAL DR, BLACKSBURG, VA 24060-7023
(540) 961-1591
Mailing address
830 HOSPITAL DR, BLACKSBURG, VA 24060-7023
(540) 961-1591
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366486664
—
VA
05
—
3810003897
—
WV
01
—
DE2036
RR MEDICARE
—
Enumeration date
06/16/2006
Last updated
08/27/2007
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