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Individual
MICHELLE CORNACCHIA
Active
Individual
MICHELLE CORNACCHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10046578
TX
207R00000X
Internal Medicine Physician
Primary
MD460596
PA
208000000X
Pediatrics Physician
BP10046578
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10046578
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
574037
PHYSICIAN IN TRAINING BASIC POSTGRADUATE TRAINING PERMIT
TX
Enumeration date
05/07/2013
Last updated
08/31/2020
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