Provider Demographics
NPI:1619931474
Name:CUMMINGS, MICHAEL ROWELL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROWELL
Last Name:CUMMINGS
Suffix:
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:PO BOX 100559
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-0559
Mailing Address - Country:US
Mailing Address - Phone:843-664-4300
Mailing Address - Fax:843-664-4308
Practice Address - Street 1:203 W 8TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-5630
Practice Address - Country:US
Practice Address - Phone:509-586-6445
Practice Address - Fax:509-586-5183
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020519207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1037001Medicaid
WACU0612OtherBCBS
A07148Medicare UPIN
WAGAB14268Medicare PIN