Provider Demographics
NPI:1326153503
Name:CUNNINGHAM, THOMAS PATRICK III (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:PATRICK
Last Name:CUNNINGHAM
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:SUITE 546
Mailing Address - City:NEWTON LOWER FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1650
Mailing Address - Country:US
Mailing Address - Phone:617-964-5020
Mailing Address - Fax:617-964-3033
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:SUITE 546
Practice Address - City:NEWTON LOWER FALLS
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:617-964-5020
Practice Address - Fax:617-964-3033
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA39558207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA62143OtherHARVARD PILGRIM HEALTHCAR
MA0402220OtherUNITED HEALTHCARE
MA2070278Medicaid
MAB33496OtherBLUE SHIELD
MA039558OtherTUFTS HEALTH PLAN
MD62143OtherPRIVATE HEALTHCARE SYSTEM
MAB10417901OtherCIGNA HEALTHCARE
MA110045880OtherRAILROAD MEDICARE
MA62143OtherHARVARD PILGRIM HEALTHCAR
MA2070278Medicaid
MAB33496Medicare ID - Type Unspecified