Individual
DESMOND B MCDONAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
036-046231
IL
2086S0129X
Vascular Surgery Physician
Primary
036046231
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01622308
BXBS
IL
Enumeration date
03/22/2006
Last updated
05/20/2008
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