Individual
CHRISTOPHER G CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 S RAVENEL ST, SUITE 230, FLORENCE, SC 29506-2644
(843) 777-3850
(843) 777-7041
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 777-3850
(843) 665-8908
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
28693
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286933
—
SC
01
—
5906489
NC MEDICAID
NC
Enumeration date
10/25/2005
Last updated
02/01/2021
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