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Individual

SAMUEL MONTGOMERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-3658
Mailing address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-3658

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
164516
NC

Other

Enumeration date
04/13/2010
Last updated
12/21/2011
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