Individual
JASON DAVID CUNDIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
135 COMMONWEALTH DR STE 210, GREENVILLE, SC 29615-4850
(864) 675-4815
(877) 893-3779
Mailing address
PO BOX 631341, CINCINNATI, OH 45263-1341
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
025774
LA
208600000X
Surgery Physician
Primary
88865
SC
208600000X
Surgery Physician
ME134536
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023066800
—
FL
Enumeration date
03/19/2008
Last updated
03/15/2024
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