1851547541 NPI number — MCCORMICK MEDICAL ASSOCIATES PC

Table of content: (NPI 1851547541)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851547541 NPI number — MCCORMICK MEDICAL ASSOCIATES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCCORMICK MEDICAL ASSOCIATES PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851547541
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

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

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2708 BROWNSVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15227-2035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-885-6330
Provider Business Practice Location Address Fax Number:
412-885-3277
Provider Enumeration Date:
08/13/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCCORMICK
Authorized Official First Name:
LEE
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
412-885-6330

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD026803L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 470259 . This is a "HIGHMARK (GRP)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0006181510001 . This is a "PA MEDICAL ASSISTANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".