Provider Demographics
NPI:1740253301
Name:MCDONALD, JEROME MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JEROME
Middle Name:MICHAEL
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10313 INTERLAAKEN DR SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-5642
Mailing Address - Country:US
Mailing Address - Phone:253-588-5448
Mailing Address - Fax:253-968-5900
Practice Address - Street 1:1405 CENTERVILLE RD STE 5000
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4663
Practice Address - Country:US
Practice Address - Phone:850-878-6164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2024-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2000152166208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)