DR. MARK DOUGLAS CUNNINGHAM (NPI# 1548290950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548290950 |
| Entity Type | Individual |
| Full Name | DR. MARK DOUGLAS CUNNINGHAM |
| Credential | D.O. |
| Practice Address |
Highway 1 Red Lake MN 56671-0249 |
| Mailing Address |
Hwy 1 24760 Hospital Drive Red Lake MN 56671-0249 |
| Practice Telephone | 2186793912 |
| Practice Fax Number | 2186790135 |
| Mailing Telephone | 2186793912 |
| Mailing Fax Number | 2186790135 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 42179 | MN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770601387 | Mark E Cunningham | Physical Therapist | 35249 Kenai Spur Hwy, Ste C, Soldotna, AK 99669-7623 | 2007-03-26 |
| 1558338764 | Mark Roy Cunningham | Physical Therapist | 542 Berlin Cross Keys Rd, Suite 1, Sicklerville, NJ 08081-4367 | 2006-03-07 |
| 1588641930 | Mark Alan Cunningham | Anesthesiology | 4215 Lynn Dr, El Dorado, AR 71730-8670 | 2005-12-28 |
| 1174621593 | Mark Alan Cunningham | Surgery | 1125 East Spruce Avenue, Suite 101, Fresno, CA 93720-3330 | 2006-09-20 |
| 1003926247 | Mark T Cunningham | Pathology | 3901 Rainbow Blvd, Dept of Pathology, Kansas City, KS 66160 | 2006-08-30 |
| 1881629566 | Mark Joseph Cunningham | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1520 San Pablo St, Suite 4300, Los Angeles, CA 90033-5310 | 2006-07-11 |
| 1326041146 | Mark L Cunningham | Physical Medicine & Rehabilitation | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2005-05-24 |
| Street Address |
HIGHWAY 1 |
| City | RED LAKE |
| State | MN |
| Zip Code | 56671-0249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902886427 | Mark W Sellers | Pharmacist | Highway 1, Red Lake, MN 56671 | 2006-01-19 |
| 1063447605 | Michael Anthony P Borromeo | Internal Medicine | Highway 1, Ihs Box 165, Red Lake, MN 56671-0165 | 2006-07-12 |
| 1356370993 | Kathleen Marmorine | Nurse Practitioner | Highway 1, Box 497, Red Lake, MN 56671-0497 | 2006-07-03 |
| 1073543484 | Tracy Brower | Nurse Practitioner | Highway 1, Red Lake, MN 56671-0249 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063030419 | Red Lake Homeless Shelter Inc. | Case Management | 15855 Main Ave, Red Lake, MN 56671 | 2020-07-13 |
| 1376026153 | Children's Healing Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 25060 Hwy 1 East, Red Lake, MN 56671 | 2018-09-08 |
| 1003332057 | Red Lake Detention Outpatient | Substance Abuse Rehabilitation Facility | 25064 Highway 1 East, Red Lake, MN 56671 | 2017-08-21 |
| 1831642214 | Jennifer Franke | Pharmacist | 24760 Hospital Rd., Red Lake, MN 56671 | 2016-08-02 |
| 1538445978 | Hoaibac Nguyen | Pharmacist | 24760 Hospital Rd, Red Lake, MN 56671 | 2011-10-31 |
| 1639466048 | Red Lake Comprehensive Health Services | Dental Hygienist | 24809 Hospital Drive, Highway 1, Redlake, MN 56671 | 2011-07-06 |
| 1821391822 | Jill Christine Andersen | Physical Therapist | Hwy 1 Hospital Dr. Box 497, Red Lake, MN 56671 | 2010-12-13 |
| 1871802934 | Elizabeth Vivian Rose | Dentist | 24760 Hospital Dr., Red Lake, MN 56671 | 2010-10-06 |
| 1225202625 | Redlake Chemical Health Program Group Home | Substance Abuse Rehabilitation Facility | 15797 Main Avenue, Redlake, MN 56671 | 2008-04-16 |
| 1104029388 | Shannon Carl Nelson | General Acute Care Hospital | Highway 1 Box 497, Red Lake, MN 56671 | 2007-06-06 |
| Find all providers in zip 56671 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922181676 | Paul M Ditmanson | Family Medicine | Hwy 1 Box 497, Phs Indian Hospital, Red Lake, MN 56671 | 2006-10-23 |
| 1740360163 | John J Pieniazek | Family Medicine | Hwy 1, Red Lake, MN 56671 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295349280 | Anna Dalrymple | Family Medicine | 3832 Mcknight Rd N, White Bear Lake, MN 55110-4874 | 2020-09-07 |
| 1760005771 | Revive Pain Centers Pa | Family Medicine | 14525 Highway 7 Ste 375, Minnetonka, MN 55345-3741 | 2020-05-26 |
| 1245862697 | North Iowa Mercy Clinics | Family Medicine | 2440 Bridge Ave, Albert Lea, MN 56007-2005 | 2020-02-04 |
| 1477196715 | The Doctors Medical Clinic, P.a. | Family Medicine | 1504 Whitebear Ave, St Paul, MN 55106 | 2019-10-18 |
| 1699336511 | Ruth Archibald | Family Medicine | 6962 Cottonwood Ct Nw, Rochester, MN 55901-8835 | 2019-06-21 |
| 1295399251 | Roberta Lynn Kopel | Family Medicine | 1605 W Lincoln Ave, Olivia, MN 56277-1260 | 2019-04-25 |
| 1558834390 | Donna Mae Mullenix | Family Medicine | 2849 Cty Rd 103, Barnum, MN 55707 | 2019-01-04 |
| 1083189203 | Altru Health System | Family Medicine | 23076 347th Street Se, Erskine, MN 56535-9466 | 2018-10-04 |
| 1477039204 | Dollar Clinic Pllc | Family Medicine | 1002 1st Ave N, Moorhead, MN 56560-2003 | 2018-07-16 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.