Individual
TERENCE JAMES MCCORMALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3650 JOSEPH SIEWICK DR, STE 400, FAIRFAX, VA 22033-1710
(703) 391-2020
(703) 391-1211
Mailing address
950N GLEBE RD 4000, ARLINGTON, VA 22203-1824
(571) 295-7514
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101041708
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05603480
—
VA
01
—
080182896
RR MEDICARE
VA
Enumeration date
09/09/2005
Last updated
11/27/2023
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