MEDICARE: DIONNE MCCORMICK

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	347C00000X	Private Vehicle	RP001805	OH

General Provider Information

NPI Number	:	1164205472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIONNE MCCORMICK

Provider Business Mailing Address
First Line	:	821 GREENWOOD AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44320-1860
Country	:	US
Telephone Number	:	330-760-6618
Fax Number	:

Provider Business Practice Location Address
First Line	:	821 GREENWOOD AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44320-1860
Country	:	US
Telephone Number	:	330-760-6618
Fax Number	:

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

Provider Enumeration Date	:	08/18/2023
Last Update Date	:	08/18/2023

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Directions to “ DIONNE MCCORMICK ” Practice Location

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