# DR. MICHAEL MELVIN FUENFER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1962575936
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 49938 | NH | — |
| 2086S0120X | Pediatric Surgery Physician | 028157 | CT | Yes |

## Other

- **Enumeration date:** 11/16/2006
- **Last updated:** 03/13/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1962575936 | — | CT |