Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 10618 | NJ |
Y | 213EG0000X | General Practice | 10618 | NJ |
NPI | 1003827353 |
---|---|
Provider Name | Dr. John R Mcdermott |
First Address | Pitman, NJ 08071-1572 |
Second Address | Pitman, NJ 08071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 08/07/2007 |