Fundaro, Gina

Fundaro, Gina is an individual health care provider with primary practice located at 4100 John R St , Detroit MI 48201-2013. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Fundaro, Gina can be contacted via phone (313) 745-8042.

Contact Information

Primary practice address
4100 John R St Detroit MI 48201-2013
Phone: (313) 745-8042
Fax: (313) 745-2314
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 4301074481 Michigan
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 4301074481 Michigan

Profile Details

NPI number 1275520512
LBN Legal business name Fundaro, Gina
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2005
Last updated Oct 7th, 2020 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275520512 NPPES
Michigan Other 7005261920 BCBS

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