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Individual

BRIAN WILLIAM CORNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
55 MEMORIAL BOULEVARD, NEWPORT, RI 02840-3679
(401) 846-2800
(401) 849-4899
Mailing address
55 MEMORIAL BOULEVARD, NEWPORT, RI 02840-3679
(401) 846-2800
(401) 849-4899

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DPM00195
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2700178
UNITED HEALTHCARE
RI
01
71215
BLUE CROSS BLUE SHIELD
RI
05
9007121
RI
Enumeration date
11/06/2006
Last updated
07/08/2007
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