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Individual
KENELM MCCORMICK
Active
Individual
KENELM MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35058973
OH
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
35058973
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000380130
ANTHEM
OH
05
—
0824433
—
OH
Enumeration date
10/04/2006
Last updated
12/09/2017
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