Provider Demographics
NPI:1093749301
Name:CUNNINGHAM, SHELBY LYNN (MD)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:LYNN
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:LYNN
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:112 AIRPORT BUSINESS PARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-7452
Mailing Address - Country:US
Mailing Address - Phone:931-685-4856
Mailing Address - Fax:931-685-4861
Practice Address - Street 1:112 AIRPORT BUSINESS PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-7452
Practice Address - Country:US
Practice Address - Phone:931-685-4856
Practice Address - Fax:931-685-4861
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41035207V00000X
AL29641207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3735059Medicaid
TN3735059Medicaid