Provider Demographics
NPI:1598282493
Name:CUNNINGHAM, ROBERT M (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:210 E DERENNE AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6736
Mailing Address - Country:US
Mailing Address - Phone:912-644-5300
Mailing Address - Fax:912-644-5241
Practice Address - Street 1:202 NEXTON SQUARE DR
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-7911
Practice Address - Country:US
Practice Address - Phone:854-429-4263
Practice Address - Fax:843-767-8569
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA008436363A00000X
SC3021363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant