Individual
MICHAEL P. MCCORMICK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
901 ENTERPRISE PKWY, SUITE 500, HAMPTON, VA 23666-6249
(757) 896-4900
(757) 896-4905
Mailing address
901 ENTERPRISE PKWY STE 500, SUITE 500, HAMPTON, VA 23666-6253
(757) 896-4900
(757) 896-4905
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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