Provider Demographics
NPI:1659353027
Name:CUNNINGHAM, DAVID JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3 IRONGATE CENTER
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3471
Mailing Address - Country:US
Mailing Address - Phone:518-793-4409
Mailing Address - Fax:518-793-5886
Practice Address - Street 1:3 IRONGATE CENTER
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3471
Practice Address - Country:US
Practice Address - Phone:518-793-4409
Practice Address - Fax:518-793-5886
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2021-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY218554207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5998716OtherGHI
NY27V731OtherBLUE CROSS BLUE SHIELD
NY000021202440OtherFIDELIS
NY000496674001OtherBLUE SHIELD WNY
NY080159576OtherRAILROAD MEDICARE
NY000000056825OtherGHI-HMO
NY08952OtherMVP
NY10048591OtherCDPHP
NYCD1981OtherRAILROAD MEDICARE GROUP #
NYNY0065274OtherTRICARE
NY00025171701OtherUNIVERA
NY7752353OtherAETNA
NY000496674001OtherBLUE SHIELD NENY
NY02116425Medicaid
NY10472731OtherCAQH
NY000496674001OtherBLUE SHIELD NENY