Provider Demographics
NPI:1518992122
Name:MCCORMACK, FRANK D (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:D
Last Name:MCCORMACK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8319 FAIRWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-4611
Mailing Address - Country:US
Mailing Address - Phone:410-437-7255
Mailing Address - Fax:410-437-7255
Practice Address - Street 1:7300 VAN DUSEN RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-9463
Practice Address - Country:US
Practice Address - Phone:301-497-2058
Practice Address - Fax:301-617-8621
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0021761207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD354591100Medicaid
MD354591100Medicaid
MX21Medicare ID - Type Unspecified
MD019959D65Medicare PIN