MEDICARE: MCDERMOTT & BROGAN, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician		NV

General Provider Information

NPI Number	:	1144302175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCDERMOTT & BROGAN, LTD

Provider Business Mailing Address
First Line	:	2345 E PRATER WAY
Second Line	:	SUITE 111
City	:	SPARKS
State	:	NV
Zip	:	89434-9600
Country	:	US
Telephone Number	:	775-324-4500
Fax Number	:	775-327-4121

Provider Business Practice Location Address
First Line	:	2345 E PRATER WAY
Second Line	:	SUITE 111
City	:	SPARKS
State	:	NV
Zip	:	89434-9600
Country	:	US
Telephone Number	:	775-324-4500
Fax Number	:	775-327-4121

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	GLENDA K MICHAEL
Credential	:
Telephone Number	:	775-324-4500

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	12/18/2007

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