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Individual

DR. CARSON C CUNNINGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3250 GORDONVILLE RD STE 384, CAPE GIRARDEAU, MO 63703-5095
(573) 331-5522
(573) 331-5523
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
023960
LA
208600000X
Surgery Physician
Primary
2016007347
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1486639
LA
Enumeration date
12/08/2005
Last updated
01/22/2021
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