Cunningham, Polla Sue
Cunningham, Polla Sue is an individual health care provider with primary practice located at 1005 Mar Walt Drive Administration, Fort Walton Beach FL 32547-6796. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Cunningham, Polla Sue can be contacted via phone (850) 863-8100.Contact Information
Primary practice address
1005 Mar Walt Drive Administration
Fort Walton Beach FL 32547-6796
Phone: (850) 863-8100
Fax: (850) 862-2303
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME94647 | Florida |
Profile Details
| NPI number | 1831260256 |
|---|---|
| LBN Legal business name | Cunningham, Polla Sue |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 10th, 2006 |
| Last updated | May 4th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831260256 | NPPES |
| Alabama | MEDICAID | 101581 | |
| Alabama | Other | 41131 | |
| Alabama | MEDICAID | 278157300 | |
| Alabama | Other | 7773615 |
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