Individual
MICHELLE MONTAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2021B EMMORTON RD STE 210, BEL AIR, MD 21015-8972
(410) 569-1001
(410) 569-1569
Mailing address
107 COLUMBINE DR, WEST GROVE, PA 19390-1354
(610) 202-6899
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0005669
MD
363AM0700X
Medical Physician Assistant
C5-0000418
DE
Other
Enumeration date
08/05/2006
Last updated
07/22/2020
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