Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Cornelius W Wickersham, MD

Individual provider Internal Medicine Physician · NPI 1104893650

Cornelius W Wickersham, MD is an Internal Medicine Physician in Waterbury, Connecticut. Licensed in Connecticut. Registered with an NPI since 2006.

Licensed in
CT
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

49 Leavenworth St Ste 200
Waterbury, CT 06702-2115
Phone: (602) 317-6874
Fax: (602) 953-7767
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 013709 (CT)

Record details

NPI number1104893650
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 3, 2006
Last updated in NPPESOctober 19, 2007
Mailing address11811 N Tatum Blvd, Suite 3031, Phoenix, AZ 85028-1614

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