Provider Demographics
NPI:1871708966
Name:CUMBERLAND HEALTHCARE GROUP PLLC
Entity type:Organization
Organization Name:CUMBERLAND HEALTHCARE GROUP PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-962-3001
Mailing Address - Street 1:66 SUNRISE PARK
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-2345
Mailing Address - Country:US
Mailing Address - Phone:931-962-3001
Mailing Address - Fax:
Practice Address - Street 1:183 HOSPITAL RD
Practice Address - Street 2:SUITE #B
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2470
Practice Address - Country:US
Practice Address - Phone:931-968-1232
Practice Address - Fax:931-968-9869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1170140002Medicare NSC
3373242Medicare PIN