Healthcare Provider Details

I. General information

NPI: 1780493379
Provider Name (Legal Business Name): TAMARA CUNNINGHAM-MYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10403 HOSPITAL DR STE G-09A
CLINTON MD
20735-3134
US

IV. Provider business mailing address

811 L ST SE
WASHINGTON DC
20003-3650
US

V. Phone/Fax

Practice location:
  • Phone: 202-683-4340
  • Fax: 202-588-5971
Mailing address:
  • Phone: 202-683-4340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: