Individual
DR. ROBERT RUSSELL CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 BOGLE ST, SOMERSET, KY 42503-2873
(606) 678-0705
(606) 676-2807
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(606) 676-8186
(270) 858-6655
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
32435
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000108398
BLUE CROSS BLUE SHIELD
KY
01
—
611371633
IRS TAXPAYER ID NUMBER
KY
05
—
64324353
—
KY
Enumeration date
08/27/2006
Last updated
06/08/2021
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