Montgomery, Edwin
Montgomery, Edwin is an individual health care provider with primary practice located at N143W6515 Pioneer Rd , Cedarburg WI 53012-2705. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Montgomery, Edwin can be contacted via phone (262) 377-6933.Contact Information
Primary practice address
N143W6515 Pioneer Rd
Cedarburg WI 53012-2705
Phone: (262) 377-6933
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 14382 | Wisconsin |
Profile Details
| NPI number | 1740388099 |
|---|---|
| LBN Legal business name | Montgomery, Edwin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1740388099 | NPPES |
| Wisconsin | MEDICAID | 30964600 |
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