| Funderburk Md | |
|
250 Executive Park Blvd Winston Salem NC 27103-1534 | |
| (336) 659-9440 | |
| (336) 659-9845 |
| Full Name | Funderburk Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 250 Executive Park Blvd, Winston Salem, North Carolina |
| Authorized Official Name and Position | Amon Funderburk (OWNER) |
| Authorized Official Contact | 3366599440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Funderburk Md 250 Executive Park Blvd Winston Salem NC 27103-1534 Ph: (336) 659-9440 | Funderburk Md 250 Executive Park Blvd Winston Salem NC 27103-1534 Ph: (336) 659-9440 |
| NPI Number | 1841460326 |
|---|---|
| Provider Enumeration Date | 03/11/2008 |
| Last Update Date | 03/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841460326 | NPI | - | NPPES |
| 34172 | Other | NC | BCBSNC |
| 8934172 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 15068 (North Carolina) | Primary |
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