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Individual
MICHAEL P. MCCORMICK JR.
Active
Individual
MICHAEL P. MCCORMICK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
VA8746
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
285011
BLUE CROSS BLUE SHIELD
VA
01
—
986085
UNITED CONCORDIA
VA
Enumeration date
10/20/2006
Last updated
12/12/2014
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