Basic Information
| Provider Information | |||||||||
| NPI: | 1164458279 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUNNINGHAM | ||||||||
| FirstName: | THELMA | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 630326 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212630326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107930791 | ||||||||
| FaxNumber: | 4107930809 | ||||||||
| Practice Location | |||||||||
| Address1: | 3001 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | CHEVERLY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207851189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016186100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 02/28/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | R058843 | MD | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.