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Individual

BRIAN K MCCORMICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
298 MEMORIAL DR, SENECA, SC 29672-9443
(864) 885-7156
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
68050
SC
363LF0000X
Family Nurse Practitioner
Primary
2057
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP1836
SC
Enumeration date
09/29/2006
Last updated
07/08/2021
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