Provider Demographics
NPI:1326492869
Name:CUNNINGHAM, CHERI CAROLINE (MD)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:CAROLINE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-5122
Mailing Address - Country:US
Mailing Address - Phone:417-224-7774
Mailing Address - Fax:
Practice Address - Street 1:901 SE PLAZA AVE STE 5
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-5473
Practice Address - Country:US
Practice Address - Phone:479-273-3376
Practice Address - Fax:479-273-3468
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-13291207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology