Provider Demographics
NPI:1891137204
Name:CUNNINGHAM, MICHEAL ANTHONY
Entity Type:Individual
Prefix:MR
First Name:MICHEAL
Middle Name:ANTHONY
Last Name:CUNNINGHAM
Suffix:
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 1:14528 OWINGS AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-5907
Mailing Address - Country:US
Mailing Address - Phone:202-256-2799
Mailing Address - Fax:301-782-4164
Practice Address - Street 1:14528 OWINGS AVE
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-5907
Practice Address - Country:US
Practice Address - Phone:202-256-2799
Practice Address - Fax:301-782-4164
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor