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Individual

DR. ROBERTO A CUNANAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1322 LOCUST AVE, FAIRMONT, WV 26554
(304) 366-0700
(304) 366-9529
Mailing address
PO BOX 1112, 1322 LOCUST AVE, FAIRMONT, WV 26554
(304) 366-0700
(304) 366-9529

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
10937
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000401637
MT STATE BC/BS
WV
01
0004507104
AETNA
WV
05
0121537000
WV
01
1245264928
OHIO WORKER'S COMP
WV
01
252745
OPTIMUM CHOICE
WV
01
300041849
RR MEDICARE
WV
01
485042
NATIONAL CAPITAL PPO
WV
01
550486849 0059
CIGNA
WV
01
D49326
WV WORKER'S COMP
WV
01
WV10937
HEALTH PLAN
WV
Enumeration date
07/10/2006
Last updated
08/11/2011
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