Healthcare Provider Details

I. General information

NPI: 1003562059
Provider Name (Legal Business Name): MOLLY CUNARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2817 ROCK MERRITT AVE STOP A ATTN: CREDENTIALS OFFICE
FORT BRAGG NC
28310-0001
US

IV. Provider business mailing address

2817 ROCK MERRITT AVE STOP A ATTN: CREDENTIALS OFFICE
FORT BRAGG NC
28310-0001
US

V. Phone/Fax

Practice location:
  • Phone: 910-907-7830
  • Fax:
Mailing address:
  • Phone: 910-907-7830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number81346-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: