Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 35061024M | OH |
NPI | 1124021514 |
---|---|
Provider Name | Patrick W Mccormick |
First Address | Toledo, OH 43608-2673 |
Second Address | Toledo, OH 43608-2673 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 02/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
816228 | (05) | OH |
E76096 | (02) | OH |