Individual
SCOTT T CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 567-2180
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01058600
IN
207L00000X
Anesthesiology Physician
Primary
01058600A
IN
207R00000X
Internal Medicine Physician
01058600A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200490060
—
IN
01
—
Q00283853
RAILROAD PTAN
IN
Enumeration date
07/04/2006
Last updated
12/02/2024
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