Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 11781995-1205 | UT |
NPI | 1033506720 |
---|---|
Provider Name | Benjamin James Mccormick |
First Address | Chapel Hill, NC 27599-7235 |
Second Address | Chapel Hill, NC 27599-7235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2015 |
Last Update Date | 20/11/2021 |