Basic Information
| Provider Information | |||||||||
| NPI: | 1275522195 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CORNEA | ||||||||
| FirstName: | ANA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2205 MCCALLIE AVE | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374043230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4236982435 | ||||||||
| FaxNumber: | 4236976110 | ||||||||
| Practice Location | |||||||||
| Address1: | 2205 MCCALLIE AVE | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374043230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4236982435 | ||||||||
| FaxNumber: | 4236976110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2005 | ||||||||
| LastUpdateDate: | 02/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 37737 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 38878221 | 05 | TN | MEDICAID |