Cornejo, Juan A
Cornejo, Juan A is an individual health care provider with primary practice located at 4303 Live Oak Drive , Little River SC 29566. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Cornejo, Juan A can be contacted via phone (843) 663-8000.Contact Information
Primary practice address
4303 Live Oak Drive
Little River SC 29566
Phone: (843) 663-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 7783 | South Carolina |
Profile Details
| NPI number | 1154374445 |
|---|---|
| LBN Legal business name | Cornejo, Juan A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2006 |
| Last updated | Mar 26th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154374445 | NPPES |
| South Carolina | MEDICAID | 007838 |
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