Gina Fundaro is a General Practice in Detroit, Michigan. Gina Fundaro practices all healthcare services and medical treatments related to General Practice. The NPI Number for Gina Fundaro is 1275520512. The last update date is 2020-10-07.
Gina Fundaro's current location address is 4100 John R St, Detroit, Michigan. You can contact this provider via phone number 3137458042 and fax number 3137452314. The mailing address for Gina Fundaro is 4100 John R St, Detroit, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gina Fundaro |
|---|---|
| Address | 4100 John R St, Detroit, Michigan |
| Phone Number | 3137458042 |
| Fax Number | 3137452314 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1275520512 |
|---|---|
| Provider Enumeration Date | 2005-10-03 |
| Last Updated Date | 2020-10-07 |
Provider Mailing Address Detail
| Address | 4100 John R St |
|---|---|
| City | Detroit |
| State | Michigan (MI) |
| Post Code | 482012013 |
| Phone Number | 3137458042 |
| Fax Number | 3137452314 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
| Licence No | 4301074481 |
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Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7005261920 | MI | BCBS |
Post Comment/ Review Below
What is the Gina Fundaro's unique identification number?
The Gina Fundaro has been assigned the NPI (National Provider Identifier) Number 1275520512 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you kindly provide the complete physical address where Gina Fundaro's facilities are geographically located?
The facilities of Gina Fundaro are physically situated at the following location: 4100 John R St, Detroit, MI, 482012013.
What is Gina Fundaro's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Gina Fundaro is General Practice, and the corresponding taxonomy classification code for this specialized field is 208D00000X.
On what date did the Gina Fundaro receive its 1275520512 assignment from the Centers for Medicare & Medicaid Services?
The Gina Fundaro was assigned its 1275520512 by the Centers for Medicare & Medicaid Services on 2005-10-03.
As of what date were the Gina Fundaro's details last updated?
The information pertaining to the Gina Fundaro, including its address, specialty, and other details, was most recently updated on 2020-10-07.