Healthcare Provider Details

I. General information

NPI: 1902904451
Provider Name (Legal Business Name): GEORGES FERRON MCCORMICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 3120 US EMBASSY SAN SALVADOR
APO AA
34023
US

IV. Provider business mailing address

US DEPT OF STATE M MED QI 2401 E STREET NW
WASHINGTON DC
20522-0001
US

V. Phone/Fax

Practice location:
  • Phone: 01150325012550
  • Fax: 01150322282805
Mailing address:
  • Phone: 202-663-1662
  • Fax: 202-663-1661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG039234
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG039234
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: