Provider Demographics
NPI:1255866323
Name:CORNEL, KEITH LAURENCE APOSTOL (DO)
Entity Type:Individual
Prefix:DR
First Name:KEITH LAURENCE
Middle Name:APOSTOL
Last Name:CORNEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10786 PASTEL SUNSET CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1582
Mailing Address - Country:US
Mailing Address - Phone:331-245-5756
Mailing Address - Fax:
Practice Address - Street 1:2855 SAINT ROSE PKWY STE 110
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4812
Practice Address - Country:US
Practice Address - Phone:702-805-5678
Practice Address - Fax:702-268-7605
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NVDO3573207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program