Provider Demographics
NPI:1245404854
Name:CORNELIUS, TUNISIA FINCH (MD)
Entity Type:Individual
Prefix:DR
First Name:TUNISIA
Middle Name:FINCH
Last Name:CORNELIUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TUNISIA
Other - Middle Name:VERSHAUN
Other - Last Name:FINCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:830 GLENWOOD AVE SE STE 510-209
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1966
Mailing Address - Country:US
Mailing Address - Phone:678-589-7546
Mailing Address - Fax:678-589-7500
Practice Address - Street 1:1039 GRANT ST SE STE A-11
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315
Practice Address - Country:US
Practice Address - Phone:678-589-7546
Practice Address - Fax:678-589-7500
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA67519207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0003126483Medicaid
GA0003126483Medicaid