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General NPI Number Information
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NPI Number | 1922214972
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Entity Type | Organization
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Legal Business Name | LARRY E CUMMINS MD PC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 01/30/2014
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Provider Practice Location Address
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Address Line | 1333 FALLSTON RD
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City | SHELBY
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State | NC
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Zip | 28150-3301
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Country | US
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Telephone | 704-482-2207
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Fax | 704-482-2254
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Provider Business Mailing Address
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Address Line | PO BOX 1620
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City | SHELBY
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State | NC
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Zip | 28151-1620
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Country | US
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Telephone | 704-482-2207
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Fax | 704-482-2254
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Authorized Official
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Title or Position | CEO
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Name | DR. LARRY E CUMMINS
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Credential | MD
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Telephone | 704-482-2207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 28744
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License Number State | NC
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