Organization
CORNELL MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLEY MICHELLE CORNELL MD (OWNER)
(781) 883-7993
Entity
Organization
Contact information
Practice address
200 UNICORN PARK DR STE 302, WOBURN, MA 01801-3342
(781) 756-2308
(781) 756-4798
Mailing address
PO BOX 80556, STONEHAM, MA 02180-0006
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A23738
—
MA
Enumeration date
09/24/2020
Last updated
09/24/2020
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