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1700969219 NPI number — MICHELLE KEITH CUNNINGHAM M.D.

NPI Number: 1700969219
Health Care Provider/Practitioner: MICHELLE KEITH CUNNINGHAM M.D.

Information about “1700969219” NPI (MICHELLE KEITH CUNNINGHAM M.D.) exists in 1700969219 in HTML format HTML  |  1700969219 in plain Text format TXT  |  1700969219 in PDF (Portable Document Format) PDF  |  1700969219 in an XML format XML  formats.

NPI Number : 1700969219 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700969219",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CUNNINGHAM",
    "FirstName": "MICHELLE",
    "MiddleName": "KEITH",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "18 GOLDEN SUNSET CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "THE WOODLANDS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77381-4154",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "713-503-0656",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "17189 I 45 S STE 175",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SHENANDOAH",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77385-3323",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "936-270-4200",
    "PracticeLocationAddressFaxNumber": "936-270-4201",
    "EnumerationDate": "10/20/2006",
    "LastUpdateDate": "02/28/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207RH0002X",
          "TaxonomyName": "Hospice and Palliative Medicine (Internal Medicine) Physician",
          "LicenseNumber": "M2298",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RG0300X",
          "TaxonomyName": "Geriatric Medicine (Internal Medicine) Physician",
          "LicenseNumber": "M2298",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "M2298",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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