MEDICARE: BRIAN P 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
1	207RR0500X	Rheumatology Physician	042-0006211	VT
2	207R00000X	Internal Medicine Physician	0420006211	VT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110099936	OTHER	VT	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	OX1788	OTHER		PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821013244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN P CUNNINGHAM MD

Provider Business Mailing Address
First Line	:	PO BOX 61
Second Line	:
City	:	ARLINGTON
State	:	VT
Zip	:	05250-0061
Country	:	US
Telephone Number	:	802-375-6566
Fax Number	:	802-375-6828

Provider Business Practice Location Address
First Line	:	9 CHURCH ST
Second Line	:
City	:	ARLINGTON
State	:	VT
Zip	:	05250-0061
Country	:	US
Telephone Number	:	802-375-6566
Fax Number	:	802-375-6828

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	05/19/2016

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Directions to “ BRIAN P CUNNINGHAM MD” Practice Location

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