Individual
DR. MARK K FUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
111 COLCHESTER AVE, FLETCHER ALLEN HEALTH CARE - PATHOLOGY, BURLINGTON, VT 05401-1473
(802) 847-3000
(802) 847-3509
Mailing address
111 COLCHESTER AVE, FAHC- PATHOLOGY DEPT, BURLINGTON, VT 05401
(802) 847-3000
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
042-0010655
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010070
—
VT
Enumeration date
07/11/2006
Last updated
10/08/2013
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