MEDICARE: VERONICA MCCORMACK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1744P3200X	Prosthetics Case Management	425467	MD

General Provider Information

NPI Number	:	1124531967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA MCCORMACK

Provider Business Mailing Address
First Line	:	4410 STAMP RD STE 106
Second Line	:
City	:	MARLOW HEIGHTS
State	:	MD
Zip	:	20748-6700
Country	:	US
Telephone Number	:	240-587-7011
Fax Number	:

Provider Business Practice Location Address
First Line	:	4410 STAMP RD STE 106
Second Line	:
City	:	MARLOW HEIGHTS
State	:	MD
Zip	:	20748-6700
Country	:	US
Telephone Number	:	240-587-7011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2017
Last Update Date	:	11/15/2017

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Directions to “ VERONICA MCCORMACK ” Practice Location

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