Provider Demographics
NPI:1366459836
Name:FLOWERS, CORNELIUS (MD)
Entity Type:Individual
Prefix:
First Name:CORNELIUS
Middle Name:
Last Name:FLOWERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1996 CLIFF VALLEY WAY NE
Mailing Address - Street 2:200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2449
Mailing Address - Country:US
Mailing Address - Phone:404-636-9323
Mailing Address - Fax:404-320-6420
Practice Address - Street 1:2675 N DECATUR RD
Practice Address - Street 2:200
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6131
Practice Address - Country:US
Practice Address - Phone:404-296-1256
Practice Address - Fax:404-296-1850
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA18647207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA06BDCNZMedicare ID - Type Unspecified
GAD39869Medicare UPIN