Cornelius, Jason R

Cornelius, Jason R is an individual health care provider with primary practice located at 9645 Grove Cir N Ste 100 , Maple Grove MN 55369. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Cornelius, Jason R can be contacted via phone (763) 302-4114.

Contact Information

Primary practice address
9645 Grove Cir N Ste 100 Maple Grove MN 55369
Phone: (763) 302-4114
Fax: (763) 302-4081
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sleep Medicine 2084S0012X 48590 Minnesota
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 48590 Minnesota

Profile Details

NPI number 1982610739
LBN Legal business name Cornelius, Jason R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated May 18th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982610739 NPPES
Minnesota MEDICAID 1982610739
Minnesota Other P00733589

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