Individual
WENDY RENEE CORNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 PATEWOOD DR, SUITE B260, GREENVILLE, SC 29615-3593
(864) 454-2100
(864) 454-2101
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 797-6174
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19401
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194015
—
SC
01
—
P00660911
RR MEDICARE
SC
Enumeration date
08/19/2006
Last updated
05/20/2021
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