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NPI Code Detail

MEDICARE: DR. MICHAEL J CUNNINGHAM PHARM D

MEDICARE: DR. MICHAEL J CUNNINGHAM PHARM D
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
1183500000XPharmacist39932TX

General Provider Information

NPI Number : 1932101649
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL J CUNNINGHAM PHARM D
Provider Business Mailing Address
First Line : 1404 7TH ST
Second Line :
City : SHALLOWATER
State : TX
Zip : 79363-5102
Country : US
Telephone Number : 806-832-0567
Fax Number :
Provider Business Practice Location Address
First Line : 6104 AVENUE Q SOUTH DR
Second Line :
City : LUBBOCK
State : TX
Zip : 79412-3700
Country : US
Telephone Number : 806-472-3455
Fax Number : 806-472-3401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 07/08/2007

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