Individual
DR. MONTGOMERY C PEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 PROFESSIONAL LANE, ENTERPRISE, AL 36330
(334) 347-3404
(334) 693-0613
Mailing address
101 PROFESSIONAL LANE, ENTERPRISE, AL 36330
(334) 347-3404
(334) 393-0613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00011984
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000028378
—
AL
01
—
51028378
BLUE CROSS BLUE SHIELD
AL
Enumeration date
05/05/2006
Last updated
09/30/2016
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