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Individual

ROBERT AVERY MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 N CAROLINE ST, BALTIMORE, MD 21287-0006
(410) 955-5045
Mailing address
PO BOX 64563, BALTIMORE, MD 21264-4563
(410) 933-7440

Taxonomy

Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
175588
NY
208600000X
Surgery Physician
175588
NY
208600000X
Surgery Physician
D47982
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100411500
MD
Enumeration date
05/17/2006
Last updated
05/16/2024
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