Provider Demographics
NPI:1770790412
Name:CORNET, ANTOINE PARNELL (MD)
Entity type:Individual
Prefix:
First Name:ANTOINE
Middle Name:PARNELL
Last Name:CORNET
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 1:7520 LONG PINE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-2819
Mailing Address - Country:US
Mailing Address - Phone:703-451-3071
Mailing Address - Fax:703-451-4254
Practice Address - Street 1:7520 LONG PINE DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-2819
Practice Address - Country:US
Practice Address - Phone:703-451-3071
Practice Address - Fax:703-451-4254
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034142146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant