Mccormick, Michael R

Mccormick, Michael R is an individual health care provider with primary practice located at 3111 Gunderson Drive , Onalaska WI 54650-8512. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Mccormick, Michael R can be contacted via phone (608) 796-8630.

Contact Information

Primary practice address
3111 Gunderson Drive Onalaska WI 54650-8512
Phone: (608) 796-8630
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 9485 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1178 Wisconsin

Profile Details

NPI number 1700880333
LBN Legal business name Mccormick, Michael R
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Jul 30th, 2015 - about 10 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 1700880333 NPPES
Wisconsin MEDICAID 42989500

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