Mccormack, Michael Shawn
Mccormack, Michael Shawn is an sole proprietor health care provider with primary practice located at 1713 10Th St Ste A , Alamogordo NM 88310-5027. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mccormack, Michael Shawn can be contacted via phone (575) 439-5439.Contact Information
Primary practice address
1713 10Th St Ste A
Alamogordo NM 88310-5027
Phone: (575) 439-5439
Fax: (575) 439-0162
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 00201972 | Colorado |
| Dental Providers / General Practice | 1223G0001X | DD5553 | New Mexico |
Profile Details
| NPI number | 1891007225 |
|---|---|
| LBN Legal business name | Mccormack, Michael Shawn |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 14th, 2010 |
| Last updated | Jan 1st, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891007225 | NPPES |
| Oregon | MEDICAID | 500624011 | |
| Oregon | MEDICAID | 78337372 |
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