Provider Demographics
NPI:1033436217
Name:MCDERMOTT, MEREDITH (MD)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8671 S QUEBEC ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-5861
Mailing Address - Country:US
Mailing Address - Phone:303-805-7477
Mailing Address - Fax:
Practice Address - Street 1:8671 S QUEBEC ST STE 200
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-5861
Practice Address - Country:US
Practice Address - Phone:303-805-7477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2791222085R0204X
390200000X
CODR.00648432085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program