BRUCE A MONTGOMERY DO NPI 1689657934

NPI Information

NPI: 1689657934
Provider Name: BRUCE A MONTGOMERY, DO
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
PECOS Registration: Yes
Address: 5757 MONCLOVA RD
STE 24
MAUMEE, OH
ZIP 43537
Phone: (419) 897-2270

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NPI Details

Bruce A Montgomery, DO is a family medicine in Maumee, OH. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Bruce A Montgomery, DO NPI is 1689657934. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5757 MONCLOVA RD
STE 24
MAUMEE, OH
ZIP 43537-863
Phone: (419) 897-2270
Fax: (419) 897-2290

The NPI 1689657934 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/21/2005 and was last updated on 5/2/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		34004231M	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02111	OTHER	OHIO	PARAMOUNT HEALTH CARE
2	080155060	OTHER	OHIO	PALMETTO GBA RAILROAD MED
3	000000142183	OTHER	OHIO	ANTHEM BCBS
4	0904927	MEDICAID	OHIO
5	F47334	MEDICARE UPIN
6	0730896	MEDICARE ID-TYPE UNSPECIFIED	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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