Individual
ANDREW LEWIS CORNELIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
673D MDG, 5955 ZEAMER AVENUE, JBER, AK 99506
(907) 580-1571
(907) 580-1575
Mailing address
673D MDG, 5955 ZEAMER AVENUE, JBER, AK 99506
(907) 580-1571
(907) 580-1575
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD440780
PA
207X00000X
Orthopaedic Surgery Physician
MT193729
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT193729
GRADUATE MEDICAL TRAINEE
—
Enumeration date
04/30/2008
Last updated
11/20/2013
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