Individual
CORNELIUS W. WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5959 GATEWAY BLVD W, # 120, EL PASO, TX 79925-3331
(915) 779-1716
(915) 771-6558
Mailing address
5959 GATEWAY BLVD W, # 120, EL PASO, TX 79925-3331
(915) 779-1716
(915) 771-6558
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G1799
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U79G
BCBS
TX
05
—
134813806
—
TX
05
—
134813809
—
TX
01
—
8U4608
BCBS
TX
Enumeration date
09/20/2006
Last updated
07/30/2008
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