| Montgomery Medical Clinic | |
|
800 S Frederick Ave Ste 100 Gaithersburg MD 20877-4150 | |
| (732) 768-8939 | |
| (301) 498-1347 |
| Full Name | Montgomery Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 800 S Frederick Ave, Gaithersburg, Maryland |
| Authorized Official Name and Position | Efraim Kessous (OWNER/MD) |
| Authorized Official Contact | 7327688939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montgomery Medical Clinic 800 S Frederick Ave Ste 100 Gaithersburg MD 20877-4150 Ph: (732) 768-8939 | Montgomery Medical Clinic 800 S Frederick Ave Ste 100 Gaithersburg MD 20877-4150 Ph: (732) 768-8939 |
| NPI Number | 1447636048 |
|---|---|
| Provider Enumeration Date | 08/05/2015 |
| Last Update Date | 07/05/2023 |
| Medicare PECOS PAC ID | 8426367384 |
|---|---|
| Medicare Enrollment ID | O20151016000824 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447636048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D0070798 (Maryland) | Primary |
| 207XX0005X | Orthopaedic Surgery - Sports Medicine | D0066523 (Maryland) | Secondary |
| Provider Name | Heon Y Jang |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477729929 PECOS PAC ID: 7416018643 Enrollment ID: I20081230000591 |
| Provider Name | Eran Kessous |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1821033358 PECOS PAC ID: 3274556329 Enrollment ID: I20100715000264 |
| Provider Name | Sara E Brooks |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1811154057 PECOS PAC ID: 9830225390 Enrollment ID: I20111123000413 |
| Provider Name | Efraim Kessous |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699983858 PECOS PAC ID: 8426180589 Enrollment ID: I20121130000231 |
| Provider Name | Jonathan D Lawless |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1053677518 PECOS PAC ID: 2961774617 Enrollment ID: I20170816000719 |
| Provider Name | Marsha Mitchum |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1508192329 PECOS PAC ID: 0244549863 Enrollment ID: I20220811000425 |
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