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General NPI Number Information
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NPI Number | 1669856282
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Entity Type | Individual
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Provider Name | HUGH MCDERMOTT M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-216-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 5310 KIETZKE LN STE 104
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City | RENO
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State | NV
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Zip | 89511-2043
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Country | US
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Telephone | 775-507-4664
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 19550
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License Number State | NV
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