Individual
MRS. WENDY W. CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2871 ACTON ROAD, SUITE 100, BIRMINGHAM, AL 35243-2560
(205) 939-0023
(205) 939-4180
Mailing address
2871 ACTON ROAD, SUITE 100, BIRMINGHAM, AL 35243-2560
(205) 939-0023
(205) 939-4180
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-325
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932896
—
AL
05
—
009955735
—
AL
01
—
051512489
BLUE CROSS - 48 MED PARK
AL
01
—
051514195
BLUE CROSS - 2660 10TH AV
AL
01
—
051514938
BLUE CROSS - 860 MONT RD
AL
05
—
891004890
—
AL
Enumeration date
05/27/2006
Last updated
05/27/2011
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