Provider Demographics
NPI:1659453678
Name:MCDERMOTT, KAREN S (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:S
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2345 E PRATER WAY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434
Mailing Address - Country:US
Mailing Address - Phone:775-352-5300
Mailing Address - Fax:775-352-5334
Practice Address - Street 1:2345 E PRATER WAY
Practice Address - Street 2:SUITE 107
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434
Practice Address - Country:US
Practice Address - Phone:775-352-5300
Practice Address - Fax:775-352-5334
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV6450207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002016458Medicaid
NV002016458Medicaid
NV33693Medicare ID - Type Unspecified