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Individual

DR. JACOB CATTELL MCCORMICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
420 S 5TH AVE, WEST READING, PA 19611-2143
(484) 628-3637
Mailing address
PO BOX 13579, READING, PA 19612-3579
(484) 628-0799

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD436665
PA
207P00000X
Emergency Medicine Physician
MT188224
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MT188224
MEDICAL TRAINING LICENSE NUMBER
PA
Enumeration date
06/13/2008
Last updated
04/11/2018
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