Provider Demographics
NPI:1174790752
Name:CUNNINGHAM, CARRIE E (MD)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:E
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:435 E 70TH ST
Mailing Address - Street 2:NUMBER 21K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5342
Mailing Address - Country:US
Mailing Address - Phone:917-605-0263
Mailing Address - Fax:
Practice Address - Street 1:MASSACHUSETTS GENERAL HOSPITAL, DEPARTME
Practice Address - Street 2:55 FRUIT STREET, WACC 460
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:917-605-0263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA234847208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery