Provider Demographics
NPI:1407818719
Name:CUMMINGS, MICHAEL V (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:V
Last Name:CUMMINGS
Suffix:
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 1:5100 W TAFT RD
Mailing Address - Street 2:SUITE 3G
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-3807
Mailing Address - Country:US
Mailing Address - Phone:315-452-2968
Mailing Address - Fax:315-452-2977
Practice Address - Street 1:5100 W TAFT RD
Practice Address - Street 2:SUITE 3G
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-3807
Practice Address - Country:US
Practice Address - Phone:315-452-2968
Practice Address - Fax:315-452-2977
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109708207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00730878Medicaid
NY00730878Medicaid
NYRA7346Medicare ID - Type Unspecified
NYJ400037177Medicare PIN