Provider Demographics
NPI:1316020936
Name:CUMMINGS, MICHAEL (MPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 MORNINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-8557
Mailing Address - Country:US
Mailing Address - Phone:843-697-6176
Mailing Address - Fax:
Practice Address - Street 1:306 STATION 22 1/2 ST
Practice Address - Street 2:
Practice Address - City:SULLIVANS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29482-9756
Practice Address - Country:US
Practice Address - Phone:843-883-0054
Practice Address - Fax:843-883-0064
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC50052251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic