Provider Demographics
NPI:1508855719
Name:CUNNINGHAM, DONALD G (DO)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:G
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:15425 N GREENWAY HAYDEN LOOP STE A300
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1204
Mailing Address - Country:US
Mailing Address - Phone:480-607-1124
Mailing Address - Fax:480-607-1087
Practice Address - Street 1:15425 N GREENWAY HAYDEN LOOP STE A300
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1204
Practice Address - Country:US
Practice Address - Phone:480-607-1124
Practice Address - Fax:480-607-1087
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ0732207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C99012Medicare UPIN
08WCHTQ01Medicare Oscar/Certification