Individual
MICHAEL STEVEN MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.A.
Contact information
Practice address
25501 CHAGRIN BLVD, BEACHWOOD, OH 44122-5603
(440) 350-0832
(440) 579-0191
Mailing address
7757 AUBURN RD STE 15, PAINESVILLE, OH 44077-9604
(403) 350-0832
(440) 579-0191
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
67.000149
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2963637
—
OH
01
—
P00880293
RAILROAD MEDICARE
OH
Enumeration date
06/23/2009
Last updated
08/07/2020
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