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Individual

ROBERT R CORNWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1900 WOODLAND DR, MANITOWOC, WI 54220-9662
(920) 320-6212
(920) 684-5548
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2591
(920) 320-4155

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28727
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1568448025
BCBS
WI
05
207R00000X
WI
01
P00835713
RR MEDICARE
WI
Enumeration date
12/16/2005
Last updated
06/07/2012
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