Provider Demographics
NPI:1730380122
Name:CUNKELMAN, JACQUELINE ANISA (MD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:ANISA
Last Name:CUNKELMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:920 ELKRIDGE LANDING RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2917
Mailing Address - Country:US
Mailing Address - Phone:443-462-5010
Mailing Address - Fax:410-684-2031
Practice Address - Street 1:301 HOSPITAL DR FL 8
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061
Practice Address - Country:US
Practice Address - Phone:410-553-8160
Practice Address - Fax:314-362-3328
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2018-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0082900207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology