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NPI Code Detail

MEDICARE: GLENN DONALD CUNNINGHAM MD

MEDICARE: GLENN DONALD CUNNINGHAM MD
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
1207X00000XOrthopaedic Surgery PhysicianM001508GU

General Provider Information

NPI Number : 1629135348
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENN DONALD CUNNINGHAM MD
Provider Business Mailing Address
First Line : 850 GOVERNOR CARLOS CAMACHO ROAD
Second Line : GUAM MEMORIAL HOSPITAL AUTHORITY
City : TAMUNING
State : GU
Zip : 96913-3128
Country : US
Telephone Number : 671-647-2488
Fax Number : 671-647-2348
Provider Business Practice Location Address
First Line : 850 GOVERNOR CARLOS CAMACHO ROAD
Second Line : GUAM MEMORIAL HOSPITAL AUTHORITY
City : TAMUNING
State : GU
Zip : 96913-3128
Country : US
Telephone Number : 671-647-2488
Fax Number : 671-647-2348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2007
Last Update Date : 07/08/2007

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Directions to “ GLENN DONALD CUNNINGHAM MD” Practice Location

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