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Individual

DR. BRIAN J MCCORMACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
21 LOCUST ST, RENO, NV 89502-1316
(775) 982-5000
(775) 982-3900
Mailing address
1155 MILL ST # MCM14, RENO, NV 89502-1576
(775) 982-5262
(775) 982-5496

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4977
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11041133
CAQH
01
P00330270
RAILROAD MEDICARE
NV
Enumeration date
07/08/2005
Last updated
12/10/2020
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