Individual
CORNELIUS BOTHA GROENEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Mailing address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
49730
MN
207L00000X
Anesthesiology Physician
Primary
C191676
CA
207LP3000X
Pediatric Anesthesiology Physician
C191676
CA
207LP3000X
Pediatric Anesthesiology Physician
MD 60217883
WA
208600000X
Surgery Physician
49730
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
927687000
—
MN
Enumeration date
02/12/2007
Last updated
04/10/2024
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