Individual
BRUCE G CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E 24TH ST, KANSAS CITY, MO 64108-2776
(612) 822-2242
Mailing address
3437 HOLMES ST, KANSAS CITY, MO 64109-2360
(612) 822-2242
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2007017269
MO
Other
Enumeration date
06/24/2007
Last updated
07/08/2007
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