Provider Demographics
NPI:1609942945
Name:PAUL SHANNON CUNNINGHAM
Entity Type:Organization
Organization Name:PAUL SHANNON CUNNINGHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTHALMOOGIST
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:SHANNON
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-868-8300
Mailing Address - Street 1:9131 PISCATAWAY ROAD
Mailing Address - Street 2:#150
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735
Mailing Address - Country:US
Mailing Address - Phone:301-868-8300
Mailing Address - Fax:301-868-7250
Practice Address - Street 1:9131 PISCATAWAY ROAD
Practice Address - Street 2:#150
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735
Practice Address - Country:US
Practice Address - Phone:301-868-8300
Practice Address - Fax:301-868-7250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty