Provider Demographics
NPI:1801939079
Name:ROBERT R. CUNNINGHAM, M.D., OB-GYN, P.L.L.C.
Entity type:Organization
Organization Name:ROBERT R. CUNNINGHAM, M.D., OB-GYN, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAMAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-676-8186
Mailing Address - Street 1:341 BOGLE ST
Mailing Address - Street 2:STE. A
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2815
Mailing Address - Country:US
Mailing Address - Phone:606-676-8186
Mailing Address - Fax:606-676-8956
Practice Address - Street 1:341 BOGLE ST
Practice Address - Street 2:STE. A
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2815
Practice Address - Country:US
Practice Address - Phone:606-676-8186
Practice Address - Fax:606-676-8956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32435174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000108398OtherBLUE CROSS BLUE SHIELD
KY64324353Medicaid
KY1619085925OtherCUNNINGHAM INDIVIDUAL NPI
KY1857601Medicare ID - Type Unspecified
KY64324353Medicaid