Organization
MONTGOMERY PHYSICIAN ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANOMA BANDARA MD (PRESIDENT PHYSICIAN)
(301) 948-0098
Entity
Organization
Contact information
Practice address
19241 MONTGOMERY VILLAGE AVENUE, STE E23, MONTGOMERY VILLAGE, MD 20886-5036
(301) 948-0098
(301) 926-9180
Mailing address
19241 MONTGOMERY VILLAGE AVENUE, STE E23, MONTGOMERY VILLAGE, MD 20886-5036
(301) 948-0098
(301) 926-9180
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0031720
MD
207R00000X
Internal Medicine Physician
Primary
D0040860
MD
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
D0031720
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201502100
—
MD
Enumeration date
10/02/2006
Last updated
09/02/2010
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