MEDICARE: FRANK E CUNNINGHAM JR. 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	207Q00000X	Family Medicine Physician	35.079126	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	201763035	OTHER	OH	TAX ID
2	201763035026	OTHER	OH	CARESOURCE ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	7812378	OTHER	OH	AETNA ID
5	000000353800	OTHER	OH	ANTHEM ID
6	D7912603	OTHER	OH	CHOICECARE ID

General Provider Information

NPI Number	:	1881692820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK E CUNNINGHAM JR. MD

Provider Business Mailing Address
First Line	:	9000 N MAIN ST
Second Line	:	SUITE G-35
City	:	DAYTON
State	:	OH
Zip	:	45415-1180
Country	:	US
Telephone Number	:	937-836-4361
Fax Number	:	937-836-1140

Provider Business Practice Location Address
First Line	:	2261 PHILADELPHIA DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-1814
Country	:	US
Telephone Number	:	937-734-4141
Fax Number	:

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	01/18/2021

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