Provider Demographics
NPI:1841229424
Name:CUNNINGHAM, DAVID G (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:CUNNINGHAM
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 1:12 HOSPITAL DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1030
Mailing Address - Country:US
Mailing Address - Phone:207-363-6136
Mailing Address - Fax:207-363-4863
Practice Address - Street 1:12 HOSPITAL DR
Practice Address - Street 2:SUITE 9
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1030
Practice Address - Country:US
Practice Address - Phone:207-363-6136
Practice Address - Fax:207-363-4863
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10325207RC0000X
MA77403207RC0000X
ME14785207RC0000X
MEMD14785207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30011506Medicaid
ME272150099Medicaid
NH30011506Medicaid
MEMM7285Medicare PIN
ME272150099Medicaid