Provider Demographics
NPI:1295703841
Name:CUNDIFF, DAVID M (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:CUNDIFF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:850 KEMPSVILLE RD
Mailing Address - Street 2:STE 100C
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3920
Mailing Address - Country:US
Mailing Address - Phone:757-466-5999
Mailing Address - Fax:757-466-0321
Practice Address - Street 1:850 KEMPSVILLE RD
Practice Address - Street 2:STE 100C
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-466-5999
Practice Address - Fax:757-466-0321
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101028813207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006026958Medicaid
B08649Medicare UPIN
VA006026958Medicaid