Provider Demographics
NPI:1942229893
Name:CUNNINGHAM, MICHAEL J (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
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 1:18599 LAKE SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-1093
Mailing Address - Country:US
Mailing Address - Phone:216-383-6060
Mailing Address - Fax:216-383-5370
Practice Address - Street 1:18599 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-1093
Practice Address - Country:US
Practice Address - Phone:216-844-8500
Practice Address - Fax:216-383-5370
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-074742207RC0000X
OH35-074742207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00428928OtherRAILROAD MEDICARE
OH2100078Medicaid
741769OtherBUCKEYE
000000224385OtherUNISON
5681753OtherAETNA
363455OtherWELLCARE
000000539419OtherANTHEM
OH60070745OtherRAILROAD MEDICARE
OH2100078Medicaid
5681753OtherAETNA
363455OtherWELLCARE