Healthcare Provider Details

I. General information

NPI: 1508286311
Provider Name (Legal Business Name): DAVID MCDERMOTT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2014
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E CARROLL ST
SALISBURY MD
21801-5422
US

IV. Provider business mailing address

P.O. BOX 9234 1 MEDICAL CENTER DRIVE,
MORGANTOWN WV
26506
US

V. Phone/Fax

Practice location:
  • Phone: 410-543-7000
  • Fax:
Mailing address:
  • Phone: 304-598-4706
  • Fax: 304-598-4706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberD0090951
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: