Individual
DOUGLAS P MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
890 W FARIS RD, SUITE 520, GREENVILLE, SC 29605-4247
(864) 455-9033
(864) 455-6559
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
84
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0409
—
SC
01
—
P01044300
RR MEDICARE
SC
Enumeration date
02/08/2006
Last updated
08/21/2013
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