Provider Demographics
NPI:1942644349
Name:CORNELL, TIANYUAN YIN (MD)
Entity Type:Individual
Prefix:MS
First Name:TIANYUAN
Middle Name:YIN
Last Name:CORNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TIANYUAN
Other - Middle Name:
Other - Last Name:YIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3309 S KINGSHIGHWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-1101
Mailing Address - Country:US
Mailing Address - Phone:314-206-3700
Mailing Address - Fax:314-525-7260
Practice Address - Street 1:11102 LINDBERGH BUSINESS CT
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7810
Practice Address - Country:US
Practice Address - Phone:314-206-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170333392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry