MEDICARE: JOSEPH GERARD CUNNIFF D.C. D.O.

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	208VP0014X	Interventional Pain Medicine Physician	6414842-1204	UT
2	208100000X	Physical Medicine & Rehabilitation Physician	45952	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00959616	OTHER	UT	RAILROAD MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1013980119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH GERARD CUNNIFF D.C. D.O.

Provider Business Mailing Address
First Line	:	710 COMMERCE DR STE 200
Second Line	:
City	:	WOODBURY
State	:	MN
Zip	:	55125-4925
Country	:	US
Telephone Number	:	651-968-5201
Fax Number	:

Provider Business Practice Location Address
First Line	:	2090 WOODWINDS DR STE 100
Second Line	:
City	:	WOODBURY
State	:	MN
Zip	:	55125-2522
Country	:	US
Telephone Number	:	651-968-5201
Fax Number	:

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	07/21/2022

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Directions to “ JOSEPH GERARD CUNNIFF D.C. D.O.” Practice Location

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