Provider Demographics
NPI:1417917311
Name:MCCORMICK, CAROLYN BRUMM (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:BRUMM
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2914 N ELM ST
Mailing Address - Street 2:PBM # 121
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-3010
Mailing Address - Country:US
Mailing Address - Phone:910-674-4392
Mailing Address - Fax:866-295-6481
Practice Address - Street 1:4308 LUDGATE ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2461
Practice Address - Country:US
Practice Address - Phone:910-674-4392
Practice Address - Fax:866-295-6481
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2020-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC20317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C8076Medicare UPIN