Mcdermott, Michael James

Mcdermott, Michael James is an individual health care provider with primary practice located at 1405 Montgomery Dr , Santa Rosa CA 95405-4557. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Mcdermott, Michael James can be contacted via phone (707) 546-1922.

Contact Information

Primary practice address
1405 Montgomery Dr Santa Rosa CA 95405-4557
Phone: (707) 546-1922
Fax: (707) 546-1897
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X G73655 California
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X G73655 California

Profile Details

NPI number 1750365102
LBN Legal business name Mcdermott, Michael James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Oct 8th, 2014 - about 11 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 1750365102 NPPES
California MEDICAID 00G736550
California Other 00G736553
California Other G73655

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