Individual
LAUREN MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
230 N BROAD ST, PHILADELPHIA, PA 19102-1121
(215) 762-4157
Mailing address
230 N BROAD ST, PHILADELPHIA, PA 19102-1121
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MT202127
PA
Other
Enumeration date
06/25/2012
Last updated
06/27/2012
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