Provider Demographics
NPI:1134359581
Name:CUNNINGHAM, HEATHER DIANNE (MD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:DIANNE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:80 GARDEN COURT SUITE 200
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-920-3500
Mailing Address - Fax:831-920-3600
Practice Address - Street 1:80 GARDEN CT STE 200
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5372
Practice Address - Country:US
Practice Address - Phone:831-920-3500
Practice Address - Fax:831-920-3600
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA143134207RH0003X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA217496OtherMEDICARE PTAN