Individual
DR. BRIAN HAROLD CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1825 LOGAN AVE, EMERGENCY DEPARTMENT, WATERLOO, IA 50703-1916
(319) 235-3697
(319) 235-3844
Mailing address
1825 LOGAN AVE, EMERGENCY DEPARTMENT, WATERLOO, IA 50703-1916
(319) 235-3697
(319) 235-3844
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
37170
IA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
TEP 5009
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0798371
—
IA
01
—
70036
WELLMARK BC/BS IOWA
IA
01
—
CP7479
RAILROAD MEDICARE GROUP NUMBER
—
01
—
P00465295
RAILROAD MEDICARE PTAN
—
Enumeration date
03/09/2007
Last updated
04/21/2009
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