Individual
MATTHEW C CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 N 12TH ST STE 320, PHOENIX, AZ 85006-2848
(602) 521-3605
(602) 521-3601
Mailing address
1300 N 12TH ST STE 320, PHOENIX, AZ 85006-2848
(602) 521-3605
(602) 521-3601
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
24409
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
480020
—
AZ
Enumeration date
03/17/2006
Last updated
04/24/2017
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