Charles Howard Kornblau, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301094020 Issued in MI

Practice address

3131 N Central Ave Unit 4020
Phoenix, AZ 85012-2820

Phone

(231) 730-0275

NPI assigned

Apr 29, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Indigo Hospital Medicine - Alpena, PLC

  • Internal Medicine Physician
  • Alpena, MI
  • NPI 1740411461
  NPD (past)
• Indigo Hospital Medicine - Cadillac, PLC

  • Internal Medicine Physician
  • Cadillac, MI
  • NPI 1770734907
  NPD (past)
• Indigo Services, PLC

  • Hospitalist Physician
  • Traverse City, MI
  • NPI 1790769669

  Internal Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1356585780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 N CENTRAL AVE UNIT 4020",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122820",
            "telephone_number": "231-730-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 N CENTRAL AVE UNIT 4020",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122820",
            "telephone_number": "231-730-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNBLAU",
        "first_name": "CHARLES",
        "middle_name": "HOWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "43129",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301094020",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301094020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Koren
• Danielle Marie Koreny, DNP
• Korie Homecare
• Korie Medical Transportation
• David R Korkes, RPH
• David Korogoda
• Gordana Koroskoski
• Mavis M. Korsah
• Christina Korsak, M.D.
• Celice Korsten

• Internal Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.