Provider Demographics
NPI:1962708222
Name:CUNNINGHAM, GLADYS ORTIZ (ARDMS)
Entity type:Individual
Prefix:MRS
First Name:GLADYS
Middle Name:ORTIZ
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:ARDMS
Other - Prefix:
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Mailing Address - Street 1:1032 OLD PEACHTREE RD NW
Mailing Address - Street 2:#401-108
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-3324
Mailing Address - Country:US
Mailing Address - Phone:678-778-8998
Mailing Address - Fax:
Practice Address - Street 1:1032 OLD PEACHTREE RD NW
Practice Address - Street 2:#401-108
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-3324
Practice Address - Country:US
Practice Address - Phone:678-778-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography