Provider Demographics
NPI:1427018217
Name:MCCORMICK, JULIA ISABEL (PA)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ISABEL
Last Name:MCCORMICK
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1701 SOUTH BLVD E
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-6122
Mailing Address - Country:US
Mailing Address - Phone:248-997-9000
Mailing Address - Fax:248-997-9007
Practice Address - Street 1:3577 W 13 MILE RD
Practice Address - Street 2:SUITE 404
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-551-6900
Practice Address - Fax:248-551-6909
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MI5601001796363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP27396Medicare UPIN