Individual
SIMON M CORNELISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 ROCHE BROS WAY, NORTH EASTON, MA 02356
(781) 344-3535
(508) 535-0192
Mailing address
PO BOX 30, STOUGHTON, MA 02072-0030
(781) 344-3535
(508) 535-0192
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
208328
MA
207X00000X
Orthopaedic Surgery Physician
Primary
208328
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0143821
—
MA
Enumeration date
12/05/2005
Last updated
04/24/2026
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