Individual
DR. MICHAEL PHILLIP FUNDORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2220 N DRUID HILLS RD NE, ATLANTA, GA 30329-3117
(404) 256-2593
(770) 488-9408
Mailing address
2970 BRANDYWINE RD STE 125, ATLANTA, GA 30341-5521
(404) 256-2593
(770) 488-9408
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
82395
GA
2080P0203X
Pediatric Critical Care Medicine Physician
269973
MA
390200000X
Student in an Organized Health Care Education/Training Program
TRN16214
FL
Other
Enumeration date
06/20/2012
Last updated
04/24/2026
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