Provider Demographics
NPI:1639334808
Name:CUNNINGHAM,, LAWRENCE E JR
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:E
Last Name:CUNNINGHAM,
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 LENORE TRL
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4823
Mailing Address - Country:US
Mailing Address - Phone:757-288-6487
Mailing Address - Fax:757-410-5143
Practice Address - Street 1:109 LENORE TRL
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4823
Practice Address - Country:US
Practice Address - Phone:757-288-6487
Practice Address - Fax:757-410-5143
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-27
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications