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General NPI Number Information
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NPI Number | 1790858637
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Entity Type | Individual
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Provider Name | CHRIS ROBERT CORNELIUS M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 5170 STATE ROUTE 405
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City | MILTON
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State | PA
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Zip | 17847-7510
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Country | US
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Telephone | 570-246-4575
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Fax |
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Provider Business Mailing Address
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Address Line | 3 DOGWOOD LN
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City | RUTLAND
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State | VT
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Zip | 05701-3774
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Country | US
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Telephone | 802-345-0851
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 042-0010037
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME76538
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD486268
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License Number State | PA
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