Individual
DR. THOMAS BRIAN CORTELLESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
ONE CLINIC DRIVE, CLAYPOOL HILL, RICHLANDS, VA 24641-1100
(276) 964-6771
(276) 964-1253
Mailing address
PO BOX CVPI, RICHLANDS, VA 24641
(276) 964-6771
(276) 964-1253
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102037199
VA
207RG0100X
Gastroenterology Physician
Primary
0102037199
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
226888
ANTHEM BCBS
—
05
—
5831636
—
VA
05
—
6000379-000
—
WV
05
—
64666183
—
KY
Enumeration date
11/16/2005
Last updated
07/11/2007
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