Provider Demographics
NPI:1871596643
Name:CUMMINGS, MICHAEL LEE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEE
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:127 FOOTHILLS AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ALBANY
Mailing Address - State:KY
Mailing Address - Zip Code:42602-1076
Mailing Address - Country:US
Mailing Address - Phone:606-387-6627
Mailing Address - Fax:606-387-4178
Practice Address - Street 1:127 FOOTHILLS AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:ALBANY
Practice Address - State:KY
Practice Address - Zip Code:42602-1076
Practice Address - Country:US
Practice Address - Phone:606-387-6627
Practice Address - Fax:606-387-4178
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2008-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY23083207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64230832Medicaid
TN4400716OtherTENNESSEE MEDICAID
KYC74923Medicare UPIN
KY64230832Medicaid