Provider Demographics
NPI:1104816842
Name:KORNMEHL, ERNEST WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:WILLIAM
Last Name:KORNMEHL
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:44 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7130
Practice Address - Country:US
Practice Address - Phone:617-232-9600
Practice Address - Fax:617-232-7002
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2025-02-14
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Provider Licenses
StateLicense IDTaxonomies
MA58784207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA058784OtherTUFTS HEALTH PLAN
MA3068820Medicaid
MAJ09372OtherBCBS MA
MAJ09372OtherBCBS MA
MAJ09372Medicare ID - Type Unspecified