Individual
MARK S MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 JOHN ST, M 475, KALAMAZOO, MI 49007-5341
(269) 276-0000
(269) 276-0001
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-8419
(269) 341-8743
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301046225
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104436934
—
MI
01
—
1417961137
BCBSM - BRONSON
MI
05
—
1659358661
—
MI
Enumeration date
12/30/2005
Last updated
04/27/2012
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