MEDICARE: DR. CORNELIUS O. OPE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	D67466	MD

General Provider Information

NPI Number	:	1629066188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CORNELIUS O. OPE MD

Provider Business Mailing Address
First Line	:	28 FLINT DR
Second Line	:
City	:	NORTH EAST
State	:	MD
Zip	:	21901-3746
Country	:	US
Telephone Number	:	540-841-9241
Fax Number	:	443-877-6235

Provider Business Practice Location Address
First Line	:	14 ROGERS RD
Second Line	:	SUITE 211
City	:	NORTH EAST
State	:	MD
Zip	:	21901-3612
Country	:	US
Telephone Number	:	443-877-6194
Fax Number	:	443-877-6235

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	09/07/2023

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