Montgomery, Bruce A
Montgomery, Bruce A is an sole proprietor health care provider with primary practice located at 5757 Monclova Rd Ste 24, Maumee OH 43537-1863. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Montgomery, Bruce A can be contacted via phone (419) 897-2270.Contact Information
Primary practice address
5757 Monclova Rd Ste 24
Maumee OH 43537-1863
Phone: (419) 897-2270
Fax: (419) 897-2290
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 34004231M | Ohio |
Profile Details
| NPI number | 1689657934 |
|---|---|
| LBN Legal business name | Montgomery, Bruce A |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 21st, 2005 |
| Last updated | May 2nd, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689657934 | NPPES |
| Ohio | Other | 000000142183 | ANTHEM BCBS |
| Ohio | Other | 02111 | ANTHEM BCBS |
| Ohio | MEDICAID | 0904927 | ANTHEM BCBS |
| Ohio | Other | 080155060 | ANTHEM BCBS |
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