Provider Demographics
NPI:1023001559
Name:CUNNINGHAM, SEAN D (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:D
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9925
Mailing Address - Fax:515-875-9923
Practice Address - Street 1:1215 PLEASANT ST
Practice Address - Street 2:STE 206
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309
Practice Address - Country:US
Practice Address - Phone:515-875-9092
Practice Address - Fax:515-875-9828
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAMD-20853207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA03871Medicare UPIN