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Individual
DR. MARC S MCDERMOTT
Active
Individual
DR. MARC S MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5223923-1205
UT
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
5223923-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142817
—
MT
05
—
100503184
—
NV
05
—
121348200
—
WY
05
—
806860000
—
ID
05
—
D5339
—
UT
Enumeration date
07/03/2006
Last updated
11/09/2011
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