Individual
LAWRENCE R MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
703 TYLER ST, STE 151, SANDUSKY, OH 44870-3392
(419) 627-1056
(419) 627-6269
Mailing address
1031 PIERCE ST, SUITE D, SANDUSKY, OH 44870-4669
(419) 557-5568
(419) 557-5542
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
034991
OH
207RG0100X
Gastroenterology Physician
Primary
034991
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361791
—
OH
Enumeration date
03/15/2006
Last updated
04/03/2017
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