Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC-007572-L | PA |
N | 111NX0100X | Occupational Health | AJ-007572-L | PA |
NPI | 1831160126 |
---|---|
Provider Name | James Robert Mcdermott |
First Address | Waynesboro, PA 17268-2198 |
Second Address | Kingston, PA 18704-5731 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MC348462 | HIGHMARK BLUE SHIELD (01) | PA |
P00115858 | RAILROAD MEDICARE (01) | PA |
U79199 | (02) | PA |