Individual
ANDREW B MCCORISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
501 S POPLAR ST, ELIZABETHTOWN, NC 28337-9375
(910) 862-5100
(910) 862-1238
Mailing address
33 UNION ST, OCEAN ISLE BEACH, NC 28469-7623
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
101095
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101095
LICENSE
NC
Enumeration date
09/20/2006
Last updated
07/09/2007
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