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:
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Health care specialties

SpecialtyCodeLicense #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 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437135944 NPPES
South Carolina MEDICAID 272779
South Carolina Other AA05373365
South Carolina Other P01556670

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