Provider Demographics
NPI:1245235365
Name:KORNFIELD CHADWELL, ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:KORNFIELD CHADWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:KORNFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:100 RAWLINS DRIVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-9999
Mailing Address - Country:US
Mailing Address - Phone:302-629-4299
Mailing Address - Fax:302-628-3963
Practice Address - Street 1:100 RAWLINS DRIVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-9999
Practice Address - Country:US
Practice Address - Phone:302-629-4299
Practice Address - Fax:302-628-3963
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29024208800000X
DEC1-0009725208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE227300YZCMedicare PIN
G97156Medicare UPIN