Provider Demographics
NPI:1124021514
Name:MCCORMICK, PATRICK W (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:W
Last Name:MCCORMICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2222 CHERRY ST
Mailing Address - Street 2:STE M200
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-2673
Mailing Address - Country:US
Mailing Address - Phone:419-251-1155
Mailing Address - Fax:419-251-3868
Practice Address - Street 1:2222 CHERRY ST
Practice Address - Street 2:STE M200
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2673
Practice Address - Country:US
Practice Address - Phone:419-251-1155
Practice Address - Fax:419-251-3868
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2023-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35061024M207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH816228Medicaid
OHE76096Medicare UPIN
OHMC0686184Medicare ID - Type Unspecified