Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 010260 | MI |
NPI | 1093785776 |
---|---|
Provider Name | M E Mccormick |
First Address | Farmington Hills, MI 48334-2977 |
Second Address | Farmington Hills, MI 48334-2977 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 22/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3268772 | (05) | MI |
G19977 | (02) | MI |