Individual
MICHAEL T CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(361) 949-4976
Mailing address
4126 E 47TH PL, TULSA, OK 74135-4731
(918) 742-7043
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0045311
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010672601002
BCBSOK
OK
Enumeration date
05/06/2006
Last updated
10/30/2007
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