MEDICARE: DR. MICHAEL S. 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	207RC0000X	Cardiovascular Disease Physician	ME0063275	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548253461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL S. CUNNINGHAM M.D.

Provider Business Mailing Address
First Line	:	4205 BELFORT RD
Second Line	:	SUITE 2069
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-1471
Country	:	US
Telephone Number	:	904-296-0278
Fax Number	:

Provider Business Practice Location Address
First Line	:	4205 BELFORT RD
Second Line	:	SUITE 2069
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-1471
Country	:	US
Telephone Number	:	904-296-0278
Fax Number	:

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	02/19/2014

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Directions to “ DR. MICHAEL S. CUNNINGHAM M.D.” Practice Location

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