Provider Demographics
NPI:1700969219
Name:CUNNINGHAM, MICHELLE KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:KEITH
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 GOLDEN SUNSET CIR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-4154
Mailing Address - Country:US
Mailing Address - Phone:713-503-0656
Mailing Address - Fax:
Practice Address - Street 1:17189 I 45 S STE 175
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-3323
Practice Address - Country:US
Practice Address - Phone:936-270-4200
Practice Address - Fax:936-270-4201
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2298207RH0002X, 207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1700969219OtherNPI
TX2742187OtherUNITED HEALTHCARE
TX7958882OtherAETNA
TX9475780OtherCIGNA
TXP00420239OtherMEDICARE RAILROAD
TX0090PAOtherBCBS
TX2742187OtherUNITED HEALTHCARE