Mark T Mcdermott OD

NPI 1083680599 - Optometrist - 152W00000X

NPI Details
NPI 1083680599
Gender Male
Enumeration Date 02/24/2006
Last Updated 05/09/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
2353 RICE ST
STE 206
Phone (651) 483-8148
Fax (651) 483-3206
Business Location
2353 RICE ST
STE. 206
ROSEVILLE MN, 55113-3739, US
Phone (651) 483-8148
Fax (651) 483-3206
Taxonomy Code 152W00000X
License State Iowa
License Number 02169
Remove 1083680599 NPI Number

According to our database, Dr. Mark T Mcdermott OD NPI is 1083680599, taxonomy code is 152W00000X and license number is 02169, license state is located at Iowa. Mark T Mcdermott OD physically located at 2353 Rice St, Roseville MN, 55113. NPI Number Mark T Mcdermott OD has the Individual type.

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1083680599 NPI number is provided on an as is basis without warranty of any kind. 1083680599 is maintained by the National Plan & Provider Enumeration System. The contents of Mark T Mcdermott OD are for informational purposes only.