MEDICARE: MCCORMICK MEDICAL ASSOCIATES PC

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	207Q00000X	Family Medicine Physician	MD026803L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	470259	OTHER	PA	HIGHMARK (GRP)
2	0006181510001	OTHER	PA	PA MEDICAL ASSISTANCE

General Provider Information

NPI Number	:	1851547541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCCORMICK MEDICAL ASSOCIATES PC

Provider Business Mailing Address
First Line	:	2708 BROWNSVILLE RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15227-2035
Country	:	US
Telephone Number	:	412-885-6330
Fax Number	:	412-885-3277

Provider Business Practice Location Address
First Line	:	2708 BROWNSVILLE RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15227-2035
Country	:	US
Telephone Number	:	412-885-6330
Fax Number	:	412-885-3277

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. LEE H MCCORMICK
Credential	:	M.D.
Telephone Number	:	412-885-6330

Provider Enumeration Date	:	08/13/2008
Last Update Date	:	08/13/2008

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