Individual
DR. MICHAEL MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 DELAFIELD ST, STE 312, WAUKESHA, WI 53188-3417
(262) 547-3352
Mailing address
1111 DELAFIELD ST, STE 312, WAUKESHA, WI 53188-3417
(262) 547-3352
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
15464-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31222700
—
WI
Enumeration date
05/01/2012
Last updated
05/01/2012
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