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Individual

WAYNE MICHAEL MCDERMOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1543 AMBERLEY FOREST ROAD, VIRGINIA BEACH, VA 23453
(757) 471-7700
(757) 471-9541
Mailing address
1543 AMBERLEY FOREST ROAD, VIRGINIA BEACH, VA 23453
(757) 471-7700
(757) 471-9541

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101037511
VA
208C00000X
Colon & Rectal Surgery Physician
Primary
0101037511
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
056754
ANTHEM
VA
Enumeration date
03/23/2006
Last updated
09/21/2007
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