Individual
CHRISTOPHER CORNILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
960 JOE FRANK HARRIS PKWY SE, CARTERSVILLE, GA 30120-2129
(678) 928-9759
(678) 928-9759
Mailing address
PO BOX 200096, CARTERSVILLE, GA 30120-9002
(678) 928-9759
(678) 928-9759
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
052547
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30BDNLL
MEDICARE ID
—
05
—
674342687
—
GA
Enumeration date
02/27/2007
Last updated
11/04/2014
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