Individual
DR. JOHN ROBERT MCCORMICK-DEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
500 HARVARD ST SE, MINNEAPOLIS, MN 55455-0363
(612) 273-3000
(612) 273-4370
Mailing address
919 NORTHLAND DR, PRINCETON, MN 55371-2172
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
62156
MN
2086S0102X
Surgical Critical Care Physician
62156
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2011
Last updated
04/24/2018
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