Provider Demographics
NPI:1437258928
Name:CUNNINGHAM, DOROTHY J (MD)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:J
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:651 WASHINGTON ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4517
Mailing Address - Country:US
Mailing Address - Phone:617-734-1707
Mailing Address - Fax:617-734-1709
Practice Address - Street 1:651 WASHINGTON ST
Practice Address - Street 2:SUITE 110
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4517
Practice Address - Country:US
Practice Address - Phone:617-734-1707
Practice Address - Fax:617-734-1709
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2014-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA82037207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A20833Medicare PIN