Funderburk, Michael D

Funderburk, Michael D is an individual health care provider with primary practice located at 1557 Janmar Rd , Snellville GA 30078-5686. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Funderburk, Michael D can be contacted via phone (678) 344-8900.

Contact Information

Primary practice address
1557 Janmar Rd Snellville GA 30078-5686
Phone: (678) 344-8900
Fax: (678) 666-5201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 034138 Georgia
Allopathic & Osteopathic Physicians / Urology 208800000X 34138 Georgia

Profile Details

NPI number 1326023938
LBN Legal business name Funderburk, Michael D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2005
Last updated Dec 12th, 2019 - about 7 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 1326023938 NPPES
Georgia MEDICAID 000456332G

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