Individual
DR. LISA MARIE MACCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4231 W 16TH AVE, DENVER, CO 80204-1335
(303) 629-3721
(303) 629-2192
Mailing address
1241 W MINERAL AVE, SUITE 100, LITTLETON, CO 80120-5685
(303) 759-0854
(303) 759-0864
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
36900
CO
207P00000X
Emergency Medicine Physician
A68040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A680400
—
CA
05
—
32851871
—
CO
01
—
P00808581
RR MEDICARE
CO
Enumeration date
05/09/2006
Last updated
11/02/2011
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