Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 35-046637 | OH |
N | 2080P0210X | Pediatric Nephrologist | MD15331R | LA |
NPI | 1669439469 |
---|---|
Provider Name | Robert J Cunningham III |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44106-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 17/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0080883 | (05) | OH |
1168912 | (05) | LA |
C02149 | (02) |