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General NPI Number Information
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NPI Number | 1700969219
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Entity Type | Individual
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Provider Name | MICHELLE KEITH CUNNINGHAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 17189 I 45 S STE 175
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City | SHENANDOAH
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State | TX
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Zip | 77385-3323
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Country | US
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Telephone | 936-270-4200
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Fax | 936-270-4201
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Provider Business Mailing Address
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Address Line | 18 GOLDEN SUNSET CIR
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City | THE WOODLANDS
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State | TX
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Zip | 77381-4154
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Country | US
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Telephone | 713-503-0656
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | M2298
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | M2298
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M2298
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License Number State | TX
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