Individual
DR. MARIE C MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, DSC
Contact information
Practice address
677 HUNTINGTON AVE, BOSTON, MA 02115-6028
(617) 432-3759
(617) 432-3755
Mailing address
478 QUINOBEQUIN RD, WABAN, MA 02468-2127
(617) 965-8279
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
58490
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3193140
—
MA
Enumeration date
08/05/2006
Last updated
07/08/2007
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