Individual
MARYANN THERESE FUMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8865 W 400 N STE 130, MICHIGAN CITY, IN 46360-9596
(219) 879-5143
(219) 872-2395
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01036532A
IN
Other
Enumeration date
12/21/2006
Last updated
04/13/2023
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