Individual
DR. CHAD D MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
849 N SYRINGA ST, POST FALLS, ID 83854-8794
(208) 777-1320
(208) 777-1322
Mailing address
849 N SYRINGA ST, POST FALLS, ID 83854-8794
(208) 777-1320
(208) 777-1322
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M9014
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0083113
MEDICAID
MT
01
—
8409260
MEDICAID
WA
Enumeration date
06/28/2005
Last updated
02/06/2024
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