Individual
DR. DAVID G CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
210 MILLS AVE, GREENVILLE, SC 29605-4020
(864) 232-2779
Mailing address
1950 OLD GALLOWS RD, SUITE 520, VIENNA, VA 22182-3990
(703) 847-8899
(703) 991-0514
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
948
SC
152WC0802X
Corneal and Contact Management Optometrist
948
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51-0604811
TAX ID NO.
SC
05
—
DO9480
—
SC
Enumeration date
01/15/2006
Last updated
11/22/2017
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