Individual
DR. LAINE MONTGOMERY CORNELISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7190 CRESTWOOD BLVD, KAISER PERMANENTE FREDERICK MEDICAL CENTER, FREDERICK, MD 21703-7314
(240) 529-1700
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101249806
VA
207Q00000X
Family Medicine Physician
Primary
D72798
MD
207Q00000X
Family Medicine Physician
MD040239
DC
Other
Enumeration date
06/05/2008
Last updated
02/26/2026
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