Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101057547 | VA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 0101057547 | VA |
NPI | 1265408496 |
---|---|
Provider Name | Thomas Paul Mcdermott JR. |
First Address | North Chesterfield, VA 23225-4067 |
Second Address | Richmond, VA 23294 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 12/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6406238 | (05) | VA |
G59033 | (02) |