Organization
NICOLE B MCDERMOTT MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE B MCDERMOTT MD (PRESIDENT)
(303) 906-4078
Entity
Organization
Contact information
Practice address
1906 BLAKE AVENUE, GLENWOOD SPRINGS, CO 81601
(970) 945-6535
Mailing address
PO BOX 203, GLENWOOD SPRINGS, CO 81602-0203
(970) 945-1443
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
44410
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20939329
—
CO
Enumeration date
01/24/2008
Last updated
04/24/2008
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