MEDICARE: THOMAS PATRICK CUNNINGHAM III 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	207R00000X	Internal Medicine Physician	39558	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	110045880	OTHER	MA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	62143	OTHER	MA	HARVARD PILGRIM HEALTHCAR
2	0402220	OTHER	MA	UNITED HEALTHCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	B33496	OTHER	MA	BLUE SHIELD
5	039558	OTHER	MA	TUFTS HEALTH PLAN
6	62143	OTHER	MD	PRIVATE HEALTHCARE SYSTEM
7	B10417901	OTHER	MA	CIGNA HEALTHCARE

General Provider Information

NPI Number	:	1326153503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS PATRICK CUNNINGHAM III M.D.

Provider Business Mailing Address
First Line	:	2000 WASHINGTON ST
Second Line	:	SUITE 546
City	:	NEWTON LOWER FALLS
State	:	MA
Zip	:	02462-1650
Country	:	US
Telephone Number	:	617-964-5020
Fax Number	:	617-964-3033

Provider Business Practice Location Address
First Line	:	2000 WASHINGTON ST
Second Line	:	SUITE 546
City	:	NEWTON LOWER FALLS
State	:	MA
Zip	:	02462-1650
Country	:	US
Telephone Number	:	617-964-5020
Fax Number	:	617-964-3033

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	05/20/2008

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