Individual
BRYAN J FUNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
420 POLIFKA DR BLDG 1042, SHAW AFB, SC 29152-5100
(803) 895-6746
(803) 895-6746
Mailing address
420 POLIFKA DR BLDG 1042, SHAW AFB, SC 29152-5100
(803) 895-6746
(803) 895-6746
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
MD31441
SC
2083X0100X
Occupational Medicine Physician
MD31441
SC
Other
Enumeration date
12/27/2005
Last updated
01/25/2023
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