Individual
KEVIN C FUNK
Active
Individual
KEVIN C FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
354670-1205
UT
2085R0202X
Diagnostic Radiology Physician
M-5252
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003691600
—
ID
05
—
1801975461
—
UT
Enumeration date
11/03/2006
Last updated
09/04/2012
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