Individual
JEFFERY JAMES CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2000 GREEN RD, STE 300, ANN ARBOR, MI 48105-1598
(734) 995-3764
(734) 995-2913
Mailing address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 246-7242
(734) 246-7117
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601006474
MI
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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