Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301111533 | MI |
N | 2080P0208X | Pediatric Infectious Diseases | 35081457 | OH |
Y | 2080P0208X | Pediatric Infectious Diseases | 4301111533 | MI |
NPI | 1356340426 |
---|---|
Provider Name | Dr. Dennis John Cunningham |
First Address | Detroit, MI 48202-3450 |
Second Address | Detroit, MI 48202-3450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 28/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2347884 | (05) | OH |
CU4087762 | MEDICARE OHIO (01) | OH |
H02650 | (02) |