Provider Demographics
NPI:1376654897
Name:CUNHA, MICHAEL J (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:CUNHA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777
Mailing Address - Country:US
Mailing Address - Phone:508-379-1191
Mailing Address - Fax:508-379-1192
Practice Address - Street 1:28 MARKET ST
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777
Practice Address - Country:US
Practice Address - Phone:508-379-1191
Practice Address - Fax:508-379-1192
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45171Medicare PIN
MAU69662Medicare UPIN
MAY45171Medicare ID - Type UnspecifiedPROVIDER NUMBER