Individual
PAUL SHANNON CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9131 PISCATAWAY RD STE 150, CLINTON, MD 20735-2510
(301) 868-8300
(301) 868-7250
Mailing address
9131 PISCATAWAY RD, #150, CLINTON, MD 20735-2510
(301) 868-8300
(301) 868-7250
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D0044573
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180043653
RAIL ROAD
MD
01
—
G02102P01
MEDICARE ID TYPE UNSPECIFIED
—
Enumeration date
11/28/2006
Last updated
07/31/2012
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