Healthcare Provider Details

I. General information

NPI: 1124582960
Provider Name (Legal Business Name): WILLIAM PAUL CUNNINGHAM CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2019
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA HOSPITAL, UNIVERSITY DRIVE UNIVERSITY DRIVE
PITTSBURGH PA
15240
US

IV. Provider business mailing address

23 GREENWICH CT
OAKMONT PA
15139-1170
US

V. Phone/Fax

Practice location:
  • Phone: 412-360-6000
  • Fax:
Mailing address:
  • Phone: 412-992-8394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberSP0199464
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: