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NPI Code Detail

MEDICARE: JEAN-RONEL CORBIER MD

MEDICARE:   JEAN-RONEL  CORBIER  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
12080P0008XPediatric Neurodevelopmental Disabilities Physician2006-01910NC
22084N0402XNeurology with Special Qualifications in Child Neurology Physician200601910NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3144NEOTHERNCBCBS ID
4195352OTHERNCMEDCOST ID
57235262OTHERNCAETNA
65695931OTHERNCCIGNA HEALTHCARE

General Provider Information

NPI Number : 1225193105
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN-RONEL CORBIER MD
Provider Business Mailing Address
First Line : 1040 EDGEWATER CORP PKWY
Second Line : SUITE 106
City : INDIAN LAND
State : SC
Zip : 29707-4514
Country : US
Telephone Number : 704-541-9117
Fax Number : 704-541-9137
Provider Business Practice Location Address
First Line : 1040 EDGEWATER CORP PKWY
Second Line : SUITE 106
City : INDIAN LAND
State : SC
Zip : 29707-4514
Country : US
Telephone Number : 704-541-9117
Fax Number : 704-541-9137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2006
Last Update Date : 08/05/2015

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