Funtanilla, Marjorie V

Funtanilla, Marjorie V is an individual health care provider with primary practice located at 1711 S Stephenson Ave Suite 225, Iron Mountain MI 49801-3639. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Funtanilla, Marjorie V can be contacted via phone (906) 776-5860.

Contact Information

Primary practice address
1711 S Stephenson Ave Suite 225 Iron Mountain MI 49801-3639
Phone: (906) 776-5860
Fax: (906) 776-5833
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 4301071282 Michigan

Profile Details

NPI number 1730161555
LBN Legal business name Funtanilla, Marjorie V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Jul 10th, 2012 - about 14 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1730161555 NPPES
Minnesota Other 110191045 RR MEDICARE
Minnesota Other 1102200711 RR MEDICARE
Minnesota MEDICAID 32482700 RR MEDICARE
Minnesota MEDICAID 3498057 RR MEDICARE

Popular Providers