Individual
DR. WILLIAM J CORNETTA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
85 HERRICK ST, BEVERLY HOSPITAL, BEVERLY, MA 01915-1776
(978) 922-3000
Mailing address
PO BOX 414230, BOSTON, MA 02241-4230
(603) 893-9784
(603) 893-8886
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
34141
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220020523
RAILROAD MEDICARE
MA
05
—
6167942
—
MA
01
—
710537
TUFTS HEALTH PLAN
MA
01
—
D08052
BCBS MA
MA
01
—
DM0438
HARVARD PILGRIM
MA
Enumeration date
02/13/2006
Last updated
12/11/2009
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