Provider Demographics
NPI:1205842531
Name:MICHAEL N. CUNNINGHAM, MD PS
Entity Type:Organization
Organization Name:MICHAEL N. CUNNINGHAM, MD PS
Other - Org Name:INLAND OPTICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:509-624-5300
Mailing Address - Street 1:842 S COWLEY ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1234
Mailing Address - Country:US
Mailing Address - Phone:509-747-8900
Mailing Address - Fax:509-624-7794
Practice Address - Street 1:842 S COWLEY ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1234
Practice Address - Country:US
Practice Address - Phone:509-747-8900
Practice Address - Fax:509-624-7794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0282620001Medicare ID - Type Unspecified