Individual
MICHAEL J MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
11110 MEDICAL CAMPUS RD, STE 130, HAGERSTOWN, MD 21742-6700
(301) 665-4731
(301) 665-4711
Mailing address
11110 MEDICAL CAMPUS RD, STE 130, HAGERSTOWN, MD 21742-6700
(301) 665-4731
(301) 665-4711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0041667
MD
207RX0202X
Medical Oncology Physician
Primary
D0041667
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005 F288
BS OF DC
DC
05
—
152761400
—
MD
01
—
523047-01
BS OF MD
MD
01
—
900000660
RR MEDICARE
MD
Enumeration date
07/20/2006
Last updated
01/23/2015
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