Provider Demographics
NPI:1861291031
Name:MONTAGUE, ERIC (HIS)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:MONTAGUE
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 SILVERSIDE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-5101
Mailing Address - Country:US
Mailing Address - Phone:302-478-4942
Mailing Address - Fax:
Practice Address - Street 1:625 BARKSDALE RD STE 107
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-4535
Practice Address - Country:US
Practice Address - Phone:302-737-0747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO3-0010303237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist