Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | M9943 | TX |
Y | 2080P0203X | Pediatric Critical Care Doctor | M9943 | TX |
NPI | 1235337122 |
---|---|
Provider Name | Christopher Cunnyngham |
First Address | Oklahoma City, OK 73112-5556 |
Second Address | Oklahoma City, OK 73112-4418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 26/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
196578202 | (05) | TX |