MEDICARE: CHELSEA CORNELL

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	207ZF0201X	Forensic Pathology Physician	35.146953	OH

General Provider Information

NPI Number	:	1609379767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA CORNELL

Provider Business Mailing Address
First Line	:	11001 CEDAR AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-3022
Country	:	US
Telephone Number	:	216-721-5610
Fax Number	:

Provider Business Practice Location Address
First Line	:	11001 CEDAR AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-3022
Country	:	US
Telephone Number	:	216-721-5610
Fax Number	:

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

Provider Enumeration Date	:	03/15/2018
Last Update Date	:	11/22/2024

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Directions to “ CHELSEA CORNELL ” Practice Location

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