Marshall Wade Cunningham, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

L9037 Issued in TX

Practice address

1020 S State Highway 16
Fredericksburg, TX 78624-4471

Phone

(830) 997-4353

Fax

(830) 990-1599

NPI assigned

Nov 22, 2005

Last updated

Mar 3, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mcunningham@direct-address.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Louisiana State University Health Sciences Center

  dba LSUHSC-S Department of Surgery

  • Surgery Physician
  • Shreveport, LA
  • NPI 1104860121
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1770566861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 294145",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780294145",
            "telephone_number": "888-779-3675",
            "fax_number": "803-896-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S STATE HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244471",
            "telephone_number": "830-997-4353",
            "fax_number": "830-990-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "MARSHALL",
        "middle_name": "WADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "L9037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cross Mountain Inpatient Services PLLC
• Angela Kaye Cross, OTR
• Charles Cross, CRNA
• Carrie Novak Culpepper, RN, FNP-C
• Cameron B Culver, M.D.
• Rebecca Wendall Daley, D.O.
• Daniel B Robertson MD PA
• Brent Kyle Denny, DPT
• Rex Dickerson, D.C.
• Traci Doerre

• Plastic Surgery Physician in Fredericksburg, TX
• Providers in Fredericksburg, TX by specialty
• Plastic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.