Individual
DR. MARK L CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(901) 291-2427
Mailing address
880 GREENLEAF RD, COLDWATER, MS 38618-8133
(901) 291-2400
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
16101
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00112219
—
MS
05
—
3020096
—
TN
Enumeration date
05/24/2005
Last updated
01/14/2015
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