Provider Demographics
NPI:1033256243
Name:CUNNINGHAM, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:733 N BEERS ST
Mailing Address - Street 2:SUITE L-3
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1528
Mailing Address - Country:US
Mailing Address - Phone:732-264-5454
Mailing Address - Fax:732-264-2043
Practice Address - Street 1:733 N BEERS ST
Practice Address - Street 2:SUITE L-3
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1528
Practice Address - Country:US
Practice Address - Phone:732-264-5454
Practice Address - Fax:732-264-2043
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2010-03-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA69669207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG14217Medicare UPIN