# EDWARD BARRY MCDONOUGH JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1235107202
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | MD-55904 | IA | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | 036112730 | IL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | MD-55904 | IA | — |

## Other

- **Enumeration date:** 03/08/2006
- **Last updated:** 11/05/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036112730 | — | IL |