Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 35055529 | OH |
NPI | 1114971140 |
---|---|
Provider Name | Dr. Diane A Mccormick |
First Address | Toledo, OH 43623-4720 |
Second Address | Toledo, OH 43623-4720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 18/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0785217 | (05) | OH |
E97368 | (02) | OH |