MEDICARE: MR. ANDREW T CUNNINGHAM 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	265062	MA
2	207Q00000X	Family Medicine Physician	36138997	IL
3	207Q00000X	Family Medicine Physician	4301110449	MI
4	207Q00000X	Family Medicine Physician	MD042785	DC
5	207Q00000X	Family Medicine Physician	MD457790	PA
6	207Q00000X	Family Medicine Physician	ME130291	FL
7	207Q00000X	Family Medicine Physician	01076738A	IN
8	207Q00000X	Family Medicine Physician	101260142	VA
9	207Q00000X	Family Medicine Physician	DR.55071	CO
10	207Q00000X	Family Medicine Physician	35.129569	OH
11	207Q00000X	Family Medicine Physician	1.055403	CT
12	207Q00000X	Family Medicine Physician	2016-01630	NC
13	207Q00000X	Family Medicine Physician	25MA09870700	NJ
14	207Q00000X	Family Medicine Physician	A110180	CA
15	207Q00000X	Family Medicine Physician	278153	NY

General Provider Information

NPI Number	:	1174799944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW T CUNNINGHAM M.D.

Provider Business Mailing Address
First Line	:	64 BLEECKER ST # 151
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10012-2410
Country	:	US
Telephone Number	:	302-313-1584
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 OFFICE PARK CT STE 103
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-5948
Country	:	US
Telephone Number	:	434-248-7508
Fax Number	:

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

Provider Enumeration Date	:	05/01/2008
Last Update Date	:	06/25/2024

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