Provider Demographics
NPI:1548265556
Name:CUNNINGHAM, PATRICK C (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:C
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:2560 24TH ST
Practice Address - Street 2:STE 202
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-5390
Practice Address - Country:US
Practice Address - Phone:309-786-3395
Practice Address - Fax:309-779-3084
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0119OtherJOHN DEERE HEALTH PLAN
4796890015OtherDMERC
20062OtherIOWA HEALTH SOLUTIONS
034788OtherHEALTH ALLIANCE
IA97782OtherWELLMARK BC/BS
IL0119OtherJOHN DEERE HEALTH PLAN
IA97782OtherWELLMARK BC/BS