Individual
MRS. BONNIE SIERRA CORLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1897 OHIO DR, GROVE CITY, OH 43123-4839
(614) 875-1721
(614) 820-2337
Mailing address
1210 BROWN ST, WASHINGTON, NC 27889-4671
(252) 975-1188
(252) 975-3800
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
2002-00671
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000591600
ANTHEM
OH
05
—
2578581
—
OH
01
—
262648439
COMMERCIAL
OH
01
—
262648439028
CARESOURCE
OH
01
—
P00311905
MEDICARE PTAN
OH
Enumeration date
01/11/2006
Last updated
01/06/2022
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