MEDICARE: DR. JOHN L CUMMINGS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD07684	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003811795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN L CUMMINGS M.D.

Provider Business Mailing Address
First Line	:	506 VILLA RD
Second Line	:
City	:	NEWBERG
State	:	OR
Zip	:	97132-1833
Country	:	US
Telephone Number	:	503-538-4544
Fax Number	:	503-538-9257

Provider Business Practice Location Address
First Line	:	506 VILLA RD
Second Line	:
City	:	NEWBERG
State	:	OR
Zip	:	97132-1833
Country	:	US
Telephone Number	:	503-538-4544
Fax Number	:	503-538-9257

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	02/22/2010

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Directions to “ DR. JOHN L CUMMINGS M.D.” Practice Location

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