Provider Demographics
NPI:1932142254
Name:CORNELL, DAVID E (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:CORNELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3587
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-0587
Mailing Address - Country:US
Mailing Address - Phone:402-345-6503
Mailing Address - Fax:402-345-0309
Practice Address - Street 1:1207 S 13TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68108-0587
Practice Address - Country:US
Practice Address - Phone:402-345-6503
Practice Address - Fax:402-345-0309
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE164213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2700158OtherUNITED HEALTHCARE
349957400OtherUS DEPT OF LABOR
NE47078690200Medicaid
480018212OtherRAILROAD MEDICARE
0511113OtherIOWA MEDICAID
NE470786902OtherMIDLANDS CHOICE
87404OtherCOVENTRY HEALTHCARE NE
NE02584OtherBLUE CROSS BLUE SHIELD
NE470786902OtherCIGNA HEALTHCARE
47078690268108A001OtherTRICARE FOR LIFE
470786902OtherHEALTHCARE PREFERRED
NE470786902OtherCIGNA HEALTHCARE
470786902OtherHEALTHCARE PREFERRED