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General NPI Number Information
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NPI Number | 1235103938
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Entity Type | Individual
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Provider Name | MICHAEL A MCCORMICK D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 107 TOWN CENTER RD
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-2330
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Country | US
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Telephone | 610-401-8368
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Fax | 610-688-8643
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Provider Business Mailing Address
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Address Line | 322 EDGEHILL RD
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City | WAYNE
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State | PA
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Zip | 19087-4716
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Country | US
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Telephone | 256-483-8447
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Fax | 610-688-8643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | OS011923
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License Number State | PA
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