Individual
DR. DANIEL R MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
485 S LANDMARK AVE, BLOOMINGTON, IN 47403-5005
(812) 334-1198
(812) 334-1199
Mailing address
485 S LANDMARK AVE, BLOOMINGTON, IN 47403-5005
(812) 334-1198
(812) 334-1199
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
02001722A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200091640
—
IN
Enumeration date
07/12/2005
Last updated
10/23/2012
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