Provider Demographics
NPI:1922111608
Name:CUNANAN, ROMEL CORPUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:ROMEL
Middle Name:CORPUZ
Last Name:CUNANAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-364-7070
Mailing Address - Fax:770-251-7275
Practice Address - Street 1:203 NEWNAN CROSSING BYP
Practice Address - Street 2:KAISER PERMANENTE NEWNAN MEDICAL CENTER
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1063
Practice Address - Country:US
Practice Address - Phone:770-304-4406
Practice Address - Fax:770-251-7275
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2022-01-07
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Provider Licenses
StateLicense IDTaxonomies
GA54189207R00000X
GA054189207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA437094727AMedicaid
GA437094727AMedicaid