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Individual

BRADLEY ALAN MCCORMICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(404) 605-3775
Mailing address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-1000
(678) 312-3282

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
817059-01
NY
367500000X
Certified Registered Nurse Anesthetist
RN2289951
MA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN307854
GA

Other

Enumeration date
05/28/2020
Last updated
06/11/2024
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