Provider Demographics
NPI:1497752596
Name:CUNNINGHAM, BETH ERIN (MD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ERIN
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 1:107 RIDGELY AVE 10
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1417
Mailing Address - Country:US
Mailing Address - Phone:410-268-6464
Mailing Address - Fax:
Practice Address - Street 1:107 RIDGELY AVE 10
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1417
Practice Address - Country:US
Practice Address - Phone:410-268-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062732174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD388719ZRVCOtherMEDICARE
MDK769L357Medicare PIN
MD407635400Medicaid