MEDICARE: CUNNINGHAM AND ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	049970	GA

General Provider Information

NPI Number	:	1558781161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUNNINGHAM AND ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1988
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30081-1988
Country	:	US
Telephone Number	:	678-907-3589
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 HAMMOND DR
Second Line	:	SUITE 201
City	:	ATLANTA
State	:	GA
Zip	:	30328-5032
Country	:	US
Telephone Number	:	404-256-0114
Fax Number	:	404-256-0167

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. LYNNE CUNNINGHAM
Credential	:	M.D.
Telephone Number	:	678-907-3589

Provider Enumeration Date	:	04/22/2014
Last Update Date	:	04/22/2014

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