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Individual

ANTHONY L FUNKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3700 WASHINGTON AVE, ST MARYS MEDICAL CENTER ANESTHESIA DEPT, EVANSVILLE, IN 47750
(812) 485-4000
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 473-0181
(812) 473-5822

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01034580A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
01034580A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000040940
BLUE SHIELD
IN
01
050012748
RAILROAD MEDICARE
05
100341680
IN
05
64872799
KY
Enumeration date
06/20/2006
Last updated
05/26/2011
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