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General NPI Number Information
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NPI Number | 1730200494
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Entity Type | Organization
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Legal Business Name | THOMAS E MCCORMICK, MD, PC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 57 CHESTNUT AVE
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City | RUTLAND
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State | VT
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Zip | 05701-3409
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Country | US
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Telephone | 802-775-4000
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Fax | 802-775-5472
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Provider Business Mailing Address
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Address Line | PO BOX 6840
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City | RUTLAND
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State | VT
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Zip | 05702-6840
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Country | US
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Telephone | 802-775-4000
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Fax | 802-775-5472
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. THOMAS EDWARD MCCORMICK
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Credential |
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Telephone | 802-775-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 42000-7175
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License Number State | VT
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