Individual
DR. GREGORY MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
54 TIMBER LN, SOUTH BURLINGTON, VT 05403-7204
(802) 864-2010
Mailing address
54 TIMBER LN, SOUTH BURLINGTON, VT 05403-7204
(802) 864-2010
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
420011111
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012592
—
VT
01
—
P00374825
RAIL ROAD MEDICARE
VT
Enumeration date
05/15/2006
Last updated
02/22/2008
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