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FREDERIC THOMAS MCDERMOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
751 LIBERTY ST, MEADVILLE, PA 16335-2559
(814) 333-5145
(814) 333-5197
Mailing address
751 LIBERTY ST, MEADVILLE, PA 16335-2559
(814) 333-5145
(814) 333-5197

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD049636L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014141000004
PA
01
0656922000
INDEPENDENCE BLUE CROSS
PA
01
219928
UPMC
PA
01
747484
BLUE SHIELD
PA
Enumeration date
05/12/2006
Last updated
08/04/2010
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