Individual
DR. JANE CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
101 CENTENNIAL ST, SUITE C, LA PLATA, MD 20646
(301) 392-3700
(301) 392-3876
Mailing address
P.O. BOX 1732, LA PLATA, MD 20646
(301) 392-3700
(301) 392-3876
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15290
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147264000
DEPT OF LABOR
MD
01
—
336006
ALLIANCE
MD
01
—
53485701
BLUE CROSS OF MARYLAND
MD
01
—
650023076
RAILROAD MEDICARE
—
01
—
T628 0001
BLUE CROSS BLUE SHIELD DC
DC
01
—
TRICARE
521983163
—
Enumeration date
08/09/2006
Last updated
09/05/2008
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