Healthcare Provider Details

I. General information

NPI: 1912980418
Provider Name (Legal Business Name): JOHN T CUNNINGHAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 PITT ST
SHARON PA
16146-2102
US

IV. Provider business mailing address

100 SHENANGO AVE
SHARON PA
16146-1503
US

V. Phone/Fax

Practice location:
  • Phone: 724-342-4052
  • Fax: 724-342-4053
Mailing address:
  • Phone: 724-342-4052
  • Fax: 724-342-4053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD073399L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: