Individual
DR. ANDREA CECCARELLI CUNIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
24 MAGOTHY BEACH RD STE A, PASADENA, MD 21122-4414
(410) 255-2700
(410) 437-1962
Mailing address
1111 BENFIELD BLVD, SUITE 200, MILLERSVILLE, MD 21108-3002
(410) 729-5100
(410) 729-5156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0068440
MD
390200000X
Student in an Organized Health Care Education/Training Program
P20837
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12753739
MULTIPLAN/PHCS PROVIDER NUMBER
MD
01
—
226988
JHHC PROVIDER NUMBER
MD
05
—
418708300
—
MD
01
—
6954391
AETNA PPO
MD
01
—
7605-0106
CAREFIRST BLUE CHOICE
MD
01
—
8246382
MAMSI
MD
01
—
9385370
AETNA HMO
MD
01
—
957078-04
CAREFIRST- MD RENDERING
MD
01
—
P00794930
RAILROAD MEDICARE
MD
01
—
P18916
CAREFIRST MPOS
MD
Enumeration date
12/05/2007
Last updated
01/24/2011
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