MEDICARE: JAMES C. CUNNINGHAM 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	2085R0202X	Diagnostic Radiology Physician	74268	GA
2	2085R0202X	Diagnostic Radiology Physician	OS10705	FL
3	2085R0204X	Vascular & Interventional Radiology Physician	OS10705	FL
4	2085R0204X	Vascular & Interventional Radiology Physician	74268	GA

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	:	1154522738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES C. CUNNINGHAM D.O.

Provider Business Mailing Address
First Line	:	11995 SINGLETREE LN STE 500
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-5349
Country	:	US
Telephone Number	:	952-595-1301
Fax Number	:	612-294-4903

Provider Business Practice Location Address
First Line	:	3707 BURNT PINE DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-0855
Country	:	US
Telephone Number	:	952-595-1100
Fax Number	:	612-294-4903

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	11/05/2025

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