Individual
DR. MARIE MONIQUE MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5575 KIETZKE LN, RENO, NV 89511-2290
(775) 851-1505
(775) 851-1583
Mailing address
1155 MILL ST # MCM14, RENO, NV 89502-1576
(775) 982-5262
(775) 982-3900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9936
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11041134
CAQH
—
Enumeration date
03/22/2006
Last updated
05/28/2021
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