Individual
DR. MICHAEL D FUNDERBURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1557 JANMAR RD, SNELLVILLE, GA 30078-5686
(678) 344-8900
(678) 666-5201
Mailing address
1557 JANMAR RD, SNELLVILLE, GA 30078-5686
(678) 344-8900
(678) 666-5201
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
034138
GA
208800000X
Urology Physician
Primary
34138
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000456332G
—
GA
Enumeration date
12/07/2005
Last updated
12/12/2019
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