Mcdermott, Edward J

Mcdermott, Edward J is an sole proprietor health care provider with primary practice located at 235 Lestertown Rd , Groton CT 06340-2808. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Mcdermott, Edward J can be contacted via phone (860) 445-7478.

Contact Information

Primary practice address
235 Lestertown Rd Groton CT 06340-2808
Phone: (860) 445-7478
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 20822 Connecticut
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 20822 Connecticut

Profile Details

NPI number 1356324008
LBN Legal business name Mcdermott, Edward J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 28th, 2005
Last updated May 6th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356324008 NPPES
Connecticut Other 030963 HEALTH NET
Connecticut MEDICAID 001208222 HEALTH NET
Connecticut Other 010020822CT03 HEALTH NET

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