Individual
PATRICK EARL MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
50910
MN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
54869
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225151558
—
MN
05
—
1225151558
—
WI
Enumeration date
04/10/2007
Last updated
01/15/2021
Update your record
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