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Organization
SHORELINE PODIATRY, INC
Active
Organization
SHORELINE PODIATRY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES I MCCORMICK (PRESIDENT)
(401) 783-2424
Entity
Organization
Contact information
Practice address
24 SALT POND RD, UNIT E-1, WAKEFIELD, RI 02879-4314
(401) 783-2424
(401) 789-2095
Mailing address
24 SALT POND RD, UNIT E-1, WAKEFIELD, RI 02879-4314
(401) 783-2424
(401) 789-2095
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1358102
AETNA HMO
RI
01
—
1909A
NEIGHBORHOOD HEALTH
RI
05
—
9004977
—
RI
01
—
PT SS#-TAX ID#204928
RAILROAD MEDICARE
RI
Enumeration date
07/11/2006
Last updated
06/26/2008
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