Healthcare Provider Details

I. General information

NPI: 1699774000
Provider Name (Legal Business Name): CALHOUN D CUNNINGHAM III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 DURALEIGH RD SUITE 300
RALEIGH NC
27612-8104
US

IV. Provider business mailing address

3100 DURALEIGH RD SUITE 300
RALEIGH NC
27612-8104
US

V. Phone/Fax

Practice location:
  • Phone: 919-876-4327
  • Fax: 919-876-6800
Mailing address:
  • Phone: 919-876-4327
  • Fax: 919-876-6800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number200400479
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: