Basic Information
| Provider Information | |||||||||
| NPI: | 1508855719 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUNNINGHAM | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4350 N 19TH AVE | ||||||||
| Address2: | SUITE 6 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850154602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022649191 | ||||||||
| FaxNumber: | 6025322973 | ||||||||
| Practice Location | |||||||||
| Address1: | 15425 N GREENWAY HAYDEN LOOP | ||||||||
| Address2: | SUITE A300 | ||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852601204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806071124 | ||||||||
| FaxNumber: | 4806071087 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2005 | ||||||||
| LastUpdateDate: | 07/29/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0732 | AZ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.