Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 74282 | MA |
N | 207R00000X | Internist | 74282 | MA |
N | 111NI0900X | Internist | 74282 | MA |
N | 207RC0200X | Critical Care Medicine | 74282 | MA |
N | 207RP1001X | Pulmonary Disease | 74282 | MA |
NPI | 1063496982 |
---|---|
Provider Name | Dr. Michael J Mccormick |
First Address | Milford, MA 01757-3588 |
Second Address | Hopedale, MA 01747-1311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 05/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3108805 | (05) | MA |
F61364 | (02) | MA |