Individual
MICHAEL JUDE MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 SIERRA COLLEGE DR, SUITE 235, GRASS VALLEY, CA 95945-5082
(530) 273-6530
(530) 273-3951
Mailing address
300 SIERRA COLLEGE DR, SUITE 235, GRASS VALLEY, CA 95945-5082
(530) 273-6530
(530) 273-3951
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
A068844
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0100570
—
CA
05
—
GR0100571
—
CA
Enumeration date
10/31/2006
Last updated
09/14/2018
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