Provider Demographics
NPI:1174799944
Name:CUNNINGHAM, ANDREW T (MD)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:T
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:64 BLEECKER ST # 151
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-2410
Mailing Address - Country:US
Mailing Address - Phone:302-313-1584
Mailing Address - Fax:
Practice Address - Street 1:2 OFFICE PARK CT STE 103
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-5948
Practice Address - Country:US
Practice Address - Phone:434-248-7508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA265062207Q00000X
IL36138997207Q00000X
MI4301110449207Q00000X
DCMD042785207Q00000X
PAMD457790207Q00000X
FLME130291207Q00000X
IN01076738A207Q00000X
VA101260142207Q00000X
CODR.55071207Q00000X
OH35.129569207Q00000X
CT1.055403207Q00000X
NC2016-01630207Q00000X
NJ25MA09870700207Q00000X
CAA110180207Q00000X
NY278153207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARES000Medicare UPIN