Individual
DR. EBONI NICOLE CORNISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1860 TOWN CENTER DRIVE, 260, RESTON, VA 20190-1928
(703) 709-1119
Mailing address
3391 VINELAND PLACE, DUMFRIES, VA 22026-1860
(401) 559-4382
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
01/24/2009
Last updated
09/19/2013
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