Individual
KEITH WAYNE CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1526 W GLENDALE AVE STE 104, PHOENIX, AZ 85021-8576
(602) 867-2838
Mailing address
1526 W GLENDALE AVE STE 104, PHOENIX, AZ 85021-8576
(602) 315-9689
(602) 867-1561
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25186
AZ
Other
Enumeration date
12/15/2006
Last updated
07/02/2021
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