Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | D0046328 | MD |
NPI | 1063478683 |
---|---|
Provider Name | Dr. Michael J Corcoran |
First Address | Towson, MD 21286-1336 |
Second Address | Baltimore, MD 21207-6665 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F87736 | (02) | MD |