Provider Demographics
NPI:1366407165
Name:CUMMINGS, CARY III (MD)
Entity type:Individual
Prefix:DR
First Name:CARY
Middle Name:
Last Name:CUMMINGS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17102-2414
Mailing Address - Country:US
Mailing Address - Phone:717-236-4682
Mailing Address - Fax:717-236-2423
Practice Address - Street 1:1617 N FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-2414
Practice Address - Country:US
Practice Address - Phone:717-236-4682
Practice Address - Fax:717-236-2423
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023228E207R00000X, 207RC0200X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007207360001Medicaid
PAC33423Medicare UPIN
PA0007207360001Medicaid