Provider Demographics
NPI:1508815887
Name:CUNNINGHAM, ROCHELLE M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:M
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:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-328-5720
Mailing Address - Fax:410-328-5685
Practice Address - Street 1:7106 RIDGE RD STE 155
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-3878
Practice Address - Country:US
Practice Address - Phone:443-559-8705
Practice Address - Fax:443-815-3748
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD56177207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD903002600Medicaid
WV9801272000Medicaid
VA5867380Medicaid
NJ8509506Medicaid
DE1508815887Medicaid
MD903002600Medicaid
MD390007105Medicare PIN
WV9801272000Medicaid