Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 38596 | RI |
N | 111NI0900X | Internist | 38596 | RI |
N | 207R00000X | Internist | MD10983 | CT |
N | 111NI0900X | Internist | MD10983 | CT |
N | 207RH0002X | Hospice and Palliative Medicine | 38596 | CT |
Y | 207RH0002X | Hospice and Palliative Medicine | MD10983 | RI |
NPI | 1154331031 |
---|---|
Provider Name | Rachel Mccormick |
First Address | New London, CT 06320-4700 |
Second Address | Westerly, RI 02891-2922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 21/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001385964 | (05) | CT |
H26093 | (02) | |
RM74010 | (05) | RI |