Individual
EDWIN J CUNNINGHAM JR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1265 UNION AVE, MEMPHIS, TN 38104-3415
(901) 725-5846
Mailing address
6060 PRIMACY PKWY, SUITE 241, MEMPHIS, TN 38119-5745
(901) 725-5846
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
14865
TN
207L00000X
Anesthesiology Physician
22903
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00012390
—
MS
01
—
050046696
MEDICARE RAILROAD
—
05
—
107439001
—
AR
05
—
201988706
—
MO
05
—
3006016
—
TN
01
—
3075019
BLUECROSS BLUESHIELD
TN
01
—
92419
BLUECROSS BLUESHIELD
AR
Enumeration date
12/15/2005
Last updated
11/03/2016
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