Organization
MINI-MEDIC
Active
Other names
Glenn R. McDermott, MD
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN ROBERT MCDERMOTT M.D. (OWNER)
(757) 343-4221
Entity
Organization
Contact information
Practice address
1788 REPUBLIC RD, SUITE 400, VIRGINIA BEACH, VA 23454-4552
(757) 343-4221
Mailing address
1788 REPUBLIC RD, SUITE 400, VIRGINIA BEACH, VA 23454-4552
(757) 343-4221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101034588
VA
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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