Montgomery, Stefan L
Montgomery, Stefan L is an individual health care provider with primary practice located at 853 N Church St Suite 510, Spartanburg SC 29303-3098. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Montgomery, Stefan L can be contacted via phone (864) 560-6193.Contact Information
Primary practice address
853 N Church St Suite 510
Spartanburg SC 29303-3098
Phone: (864) 560-6193
Fax: (864) 560-1510
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 27277 | South Carolina |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 27277 | South Carolina |
Profile Details
| NPI number | 1437135944 |
|---|---|
| LBN Legal business name | Montgomery, Stefan L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 16th, 2005 |
| Last updated | Feb 1st, 2021 - about 4 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 | 1437135944 | NPPES |
| South Carolina | MEDICAID | 272779 | |
| South Carolina | Other | AA05373365 | |
| South Carolina | Other | P01556670 |
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