Individual
CURTIS L CORNELLA-CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3289 N MAYFAIR RD, WAUWATOSA, WI 53222
(414) 771-7900
(414) 607-6336
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
45926
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43508400
—
WI
01
—
P00823715
RR MEDICARE
WI
Enumeration date
07/05/2006
Last updated
11/30/2021
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