Provider Demographics
NPI:1548221666
Name:CUNNIFF, GERALD JOSEPH JR (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:JOSEPH
Last Name:CUNNIFF
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-5000
Mailing Address - Fax:
Practice Address - Street 1:2805 DODD RD
Practice Address - Street 2:STE. 100
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-2159
Practice Address - Country:US
Practice Address - Phone:651-241-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40671207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN160003412Medicare PIN