Provider Demographics
NPI:1861678526
Name:CUMMINGS, STEPHEN D (CH)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:CH
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 890
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-0890
Mailing Address - Country:US
Mailing Address - Phone:928-782-4339
Mailing Address - Fax:
Practice Address - Street 1:281 W 24TH ST
Practice Address - Street 2:STE 140
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8500
Practice Address - Country:US
Practice Address - Phone:928-782-4339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4171111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00169227OtherRAILROAD MEDICARE