Provider Demographics
NPI:1043715170
Name:MCDERMOTT, LAWRENCE MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:MICHAEL
Last Name:MCDERMOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 EXETER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22603-8614
Mailing Address - Country:US
Mailing Address - Phone:540-686-1600
Mailing Address - Fax:
Practice Address - Street 1:160 EXETER DR STE 104
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-8614
Practice Address - Country:US
Practice Address - Phone:540-686-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012825892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology