Provider Demographics
NPI:1831364587
Name:CUNIN, KATHRYN ANN (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ANN
Last Name:CUNIN
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 1:2800 E COTTONWOOD PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-7296
Mailing Address - Country:US
Mailing Address - Phone:800-366-1884
Mailing Address - Fax:
Practice Address - Street 1:123 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2652
Practice Address - Country:US
Practice Address - Phone:207-373-6000
Practice Address - Fax:207-373-6080
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN60187207R00000X, 208M00000X
OH35.092026208M00000X, 207RH0002X
ORMD184283207R00000X
MEMD20513208M00000X, 207R00000X
CO46789207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH521710Medicare PIN