Organization
EDWARD MCDERMOTT, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD J MCDERMOTT MD (OWNER)
(860) 447-1475
Entity
Organization
Contact information
Practice address
276R MONTAUK AVE, NEW LONDON, CT 06320
(860) 447-1475
(860) 447-8598
Mailing address
276R MONTAUK AVE, NEW LONDON, CT 06320
(860) 447-1475
(860) 447-8598
Taxonomy
Speciality
Code
Description
License number
State
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
01
—
DB1041
RAILROAD MEDICARE
CT
Enumeration date
03/07/2007
Last updated
11/17/2008
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