Provider Demographics
NPI:1982870101
Name:CUNNINGHAM, STEVEN CLARK (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:CLARK
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 WILKENS AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5074
Mailing Address - Country:US
Mailing Address - Phone:443-574-8500
Mailing Address - Fax:410-719-0094
Practice Address - Street 1:3407 WILKENS AVE STE 410
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5074
Practice Address - Country:US
Practice Address - Phone:443-574-8500
Practice Address - Fax:410-719-0094
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0068549208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery