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Individual
GERALD LANE MCCORMICK
Active
Individual
GERALD LANE MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
025219
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000268177H
—
GA
Enumeration date
12/15/2006
Last updated
11/30/2011
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