Provider Demographics
NPI:1811984230
Name:CORNMAN, EDMUND W (MD)
Entity type:Individual
Prefix:DR
First Name:EDMUND
Middle Name:W
Last Name:CORNMAN
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:PO BOX 8266
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-0266
Mailing Address - Country:US
Mailing Address - Phone:804-285-0100
Mailing Address - Fax:804-285-2458
Practice Address - Street 1:1800 GLENSIDE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3769
Practice Address - Country:US
Practice Address - Phone:804-285-0100
Practice Address - Fax:804-285-2458
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012331512084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3531249OtherAETNA HMO
VA460754OtherANTHEM-COLHEIGHTS
VA7118171Medicaid
VA1821896OtherUNITED HEALTHCARE
VA64490OtherOPTIMA/SENTARA
VA460753OtherANTHEM-GLENSIDE
VA7802252OtherAETNA NONHMO
VA2110918OtherMAMSI/ALLIANCE
VA49538OtherCARENET
VA206678OtherSOUTHERN HEALTH
VA130025786OtherMEDICARE-RAILROAD
VA29493OtherCIGNA
VA29493OtherCIGNA
VA460754OtherANTHEM-COLHEIGHTS