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General NPI Number Information
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NPI Number | 1982870101
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Entity Type | Individual
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Provider Name | STEVEN CLARK CUNNINGHAM MD
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Gender | Male
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 3407 WILKENS AVE STE 410
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City | BALTIMORE
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State | MD
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Zip | 21229-5074
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Country | US
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Telephone | 443-574-8500
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Fax | 410-719-0094
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Provider Business Mailing Address
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Address Line | 3407 WILKENS AVE STE 410
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City | BALTIMORE
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State | MD
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Zip | 21229-5074
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Country | US
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Telephone | 443-574-8500
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Fax | 410-719-0094
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | D0068549
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License Number State | MD
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