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General NPI Number Information
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NPI Number | 1861618373
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Entity Type | Individual
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Provider Name | STEVEN E MCCORMACK MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 640 JACKSON ST HEALTHPARTNERS REGIONS SPECIALTY CLINICS - MC 11503F
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City | ST. PAUL
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State | MN
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Zip | 55101-2502
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Country | US
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Telephone | 651-254-3448
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Fax | 651-254-3470
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Provider Business Mailing Address
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Address Line | 8170 33RD AVE S MS21110Q
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City | MINNEAPOLIS
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State | MN
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Zip | 55425-4516
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Country | US
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Telephone |
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Fax |
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 56010-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 53949
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License Number State | MN
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