Individual
CARRIE A CUNNAGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
165 S EDWIN C MOSES BLVD, DAYTON, OH 45402-8472
(937) 558-0200
(937) 558-0201
Mailing address
PO BOX 714828, COLUMBUS, OH 43271-4828
(800) 723-3504
(513) 345-6281
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34006343
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2264535
—
OH
01
—
3601331
MEDICARE GROUP NUMBER
OH
Enumeration date
11/10/2005
Last updated
03/17/2008
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