Organization
THOMAS W MONTAG MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS W MONTAG M.D. (MANAGING MEMBER GYN ONCOLOGIST)
(757) 436-9898
Entity
Organization
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101059160
MEDICAL LICENSE
VA
05
—
621780-0
—
VA
01
—
C09977
MEDICARE GROUP NUMBER
VA
Enumeration date
07/27/2006
Last updated
10/16/2007
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