Individual
DR. PHILIP BURTON FUNDERBURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7749 MATTHEWS MINT HILL RD, MINT HILL, NC 28227-7598
(704) 545-9797
(704) 545-3111
Mailing address
1950 OLD GALLOWS RD, 520, VIENNA, VA 22182-3990
(703) 847-8899
(703) 991-0514
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
922
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8909297
—
NC
Enumeration date
03/20/2007
Last updated
11/14/2017
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