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Individual

LYNDA G MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3609 PARK EAST DR STE 210, BEACHWOOD, OH 44122-4309
(216) 245-5680
Mailing address
3609 PARK EAST DR STE 210, BEACHWOOD, OH 44122-4309
(216) 245-5680

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-081131
OH
207Q00000X
Family Medicine Physician
35.081131
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000224454
UNISON
01
000000312657
ANTHEM
OH
01
000000530394
ANTHEM
OH
05
2356114
OH
01
363854
WELLCARE
01
7375280
AETNA
OH
01
737690
BUCKEYE
01
P00333107
RAILROAD MEDICARE
OH
01
P00454363
RAILROAD MEDICARE
OH
Enumeration date
07/24/2006
Last updated
04/30/2019
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