Provider Demographics
NPI:1831501469
Name:MCCORMICK-BAW, CLARE (MD/PHD)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:MCCORMICK-BAW
Suffix:
Gender:F
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4916 SARAHS WAY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3385
Mailing Address - Country:US
Mailing Address - Phone:601-946-3248
Mailing Address - Fax:
Practice Address - Street 1:4916 SARAHS WAY
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3385
Practice Address - Country:US
Practice Address - Phone:601-946-3248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10050862207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology