Provider Demographics
NPI:1881998458
Name:CUNNINGHAM, PETER DOUGLAS (MS)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:DOUGLAS
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2837 EASTBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2364
Mailing Address - Country:US
Mailing Address - Phone:970-484-4151
Mailing Address - Fax:
Practice Address - Street 1:2121 E HARMONY RD
Practice Address - Street 2:SUITE 350
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3400
Practice Address - Country:US
Practice Address - Phone:970-484-6373
Practice Address - Fax:970-484-0382
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO200542237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist