Mccormick, Thomas R

Mccormick, Thomas R is an individual health care provider with primary practice located at 24001 Greater Mack Ave Ste B, St Clair Shores MI 48080-1407. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Mccormick, Thomas R can be contacted via phone (586) 774-5050.

Contact Information

Primary practice address
24001 Greater Mack Ave Ste B St Clair Shores MI 48080-1407
Phone: (586) 774-5050
Fax: (586) 774-1808
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 041143 Michigan

Profile Details

NPI number 1275537532
LBN Legal business name Mccormick, Thomas R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2005
Last updated Jul 15th, 2010 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275537532 NPPES
Michigan MEDICAID 3021701 TYPE 10

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