Individual
DR. EDWARD J MCDERMOTT
Active
Individual
DR. EDWARD J MCDERMOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
20822
CT
207R00000X
Internal Medicine Physician
Primary
20822
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001208222
—
CT
01
—
010020822CT03
ANTHEM BLUE CROSS
CT
01
—
030963
HEALTH NET
CT
Enumeration date
11/28/2005
Last updated
05/06/2019
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