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NPI Code Detail

MEDICARE: DR. IAN MCCORMICK MD, MPH

MEDICARE: DR. IAN MCCORMICK MD, MPH
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
1207R00000XInternal Medicine Physician0101276980VA

General Provider Information

NPI Number : 1407479710
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IAN MCCORMICK MD, MPH
Provider Business Mailing Address
First Line : 327 MEDICAL PARK DR
Second Line :
City : BRIDGEPORT
State : WV
Zip : 26330-9006
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1840 AMHERST ST
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-2808
Country : US
Telephone Number : 540-536-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2020
Last Update Date : 03/02/2026

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