Provider Demographics
NPI:1376684118
Name:CUNHA, CHRISTINE D (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:D
Last Name:CUNHA
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 1:1351 NEWTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-1217
Mailing Address - Country:US
Mailing Address - Phone:859-253-1686
Mailing Address - Fax:859-254-2743
Practice Address - Street 1:650 HIGH ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1235
Practice Address - Country:US
Practice Address - Phone:859-253-1686
Practice Address - Fax:859-254-2743
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY256452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30615058Medicaid
KY0331801Medicare ID - Type UnspecifiedMEDICARE
KY0338301Medicare ID - Type UnspecifiedMEDICARE
KY0332001Medicare ID - Type UnspecifiedMEDICARE
KY0045430Medicare ID - Type UnspecifiedMEDICARE
KY0331901Medicare ID - Type UnspecifiedMEDICARE
KY30615058Medicaid
KY0331220Medicare ID - Type UnspecifiedMEDICARE
KY0332101Medicare ID - Type UnspecifiedMEDICARE
KY0454Medicare ID - Type UnspecifiedMEDICARE