Individual
THOMAS J CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
111 GROSSMAN DR, BRAINTREE, MA 02184-4997
(781) 849-1000
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
637
MA
363AM0700X
Medical Physician Assistant
637
MA
Other
Enumeration date
04/12/2006
Last updated
10/10/2014
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