Provider Demographics
NPI:1104268838
Name:CUNNINGHAM, ROBERT M (MB CHB MPH FACS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:MB CHB MPH FACS
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Mailing Address - Street 1:2730 PIERCE ST STE 300A
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3796
Mailing Address - Country:US
Mailing Address - Phone:712-234-8725
Mailing Address - Fax:
Practice Address - Street 1:2730 PIERCE ST STE 300A
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3796
Practice Address - Country:US
Practice Address - Phone:712-234-8725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-52296208600000X
KS0444988208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery