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Individual

ALICE G MCCORMICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
5450 EAST DEER VALLEY DRIVE UNIT 3206, PHOENIX, AZ 85054
(570) 499-5144
(480) 619-4098
Mailing address
5450 EAST DEER VALLEY DRIVE UNIT 3206, PHOENIX, AZ 85054
(570) 499-5144
(480) 619-4098

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
006893
AZ
207R00000X
Internal Medicine Physician
Primary
AZ006893
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001035898
PA
Enumeration date
12/06/2005
Last updated
09/18/2019
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