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Individual

MS. KERIN A MCCORMACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
209 ABBEVILLE AVE NW, AIKEN, SC 29801-3923
(803) 306-1433
(803) 632-1209
Mailing address
86 WREN ST, BARNWELL, SC 29812-1529
(803) 259-5762
(803) 259-3250

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1484
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1338PA
SC
01
1484
MEDICAL LICENSE
SC
01
AA4884
MEDICARE
SC
Enumeration date
12/21/2009
Last updated
09/08/2023
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