Individual
JOHN MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35081423M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000233026
ANTHEM
OH
01
—
020052624
TRAVELERS MEDICARE
—
01
—
1402423
UHC
—
05
—
2333853
—
OH
01
—
311098079
TAX ID
—
01
—
353077
SUBMITTER NO
—
01
—
7794409
AETNA
—
Enumeration date
05/01/2006
Last updated
12/15/2021
Update your record
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