MARJORIE V FUNTANILLA (NPI# 1730161555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730161555 |
| Entity Type | Individual |
| Full Name | MARJORIE V FUNTANILLA |
| Credential | MD |
| Practice Address |
1711 S Stephenson Ave Suite 225 Iron Mountain MI 49801-3639 |
| Mailing Address |
Po Box 549 Iron Mountain MI 49801-0549 |
| Practice Telephone | 9067765860 |
| Practice Fax Number | 9067765833 |
| Mailing Telephone | 9067741313 |
| Mailing Fax Number | 9067765639 |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2012-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
4301071282 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3498057 | 05 | |
| MN | RR MEDICARE | 110191045 | 01 |
| WI | 32482700 | 05 | |
| MI | BCBS MI | 1102200711 | 01 |
| Street Address |
1711 S STEPHENSON AVE SUITE 225 |
| City | IRON MOUNTAIN |
| State | MI |
| Zip Code | 49801-3639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265434849 | Daniel M Mitchell | Family Medicine | 1711 S Stephenson Ave, Suite 300, Iron Mountain, MI 49801-3650 | 2005-08-12 |
| 1053883256 | Baycare Clinic, LLP | Neurological Surgery | 1711 S Stephenson Ave, Iron Mountain, MI 49801-3639 | 2018-12-28 |
| 1891176806 | Dickinson County Healthcare System | Surgery | 1711 S Stephenson Ave, Ste 305, Iron Mountain, MI 49801-3639 | 2015-06-16 |
| 1316330566 | Emily Warren | Student in an Organized Health Care Education/Training Program | 1711 S Stephenson Ave, Iron Mountain, MI 49801 | 2015-03-12 |
| 1326455015 | Dickinson County Healthcare System | Internal Medicine | 1711 S Stephenson Ave, Suite 315, Iron Mountain, MI 49801-3639 | 2014-07-15 |
| 1043635378 | Dickinson County Healthcare System | Internal Medicine | 1711 S Stephenson Ave, Suite 125, Iron Mountain, MI 49801-3639 | 2014-02-24 |
| 1992141352 | Michigan-wisconsin Family Practice Associates, P.C. | Family Medicine | 1711 S Stephenson Ave, Suite 300, Iron Mountain, MI 49801-3650 | 2013-05-13 |
| 1700125150 | Dickinson County Healthcare System | Family Medicine | 1711 S Stephenson Ave, Suite 115, Iron Mountain, MI 49801-3639 | 2013-02-05 |
| 1841534484 | Dickinson County Healthcare System | Audiologist | 1711 S Stephenson Ave, Suite 320, Iron Mountain, MI 49801-3639 | 2012-11-20 |
| 1366721953 | Jeffrey Richard Hutchinson | Audiologist | 1711 S Stephenson Ave, Suite 320, Iron Mountain, MI 49801-3639 | 2011-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770008062 | John M Baccino | Dietitian, Registered | 325 E H St # 133, Iron Mountain, MI 49801 | 2017-08-08 |
| 1699148692 | Bd Baker Rentals LLC | Optometrist | 2100 Aragon Street, Iron Mountain, MI 49801 | 2015-11-12 |
| 1083044762 | Integrated First Response-great Lakes | Ambulance | 719 River Avenue, Iron Mountain, MI 49801 | 2013-11-18 |
| 1912340936 | Andrew James Tomlinson | Social Worker | Iron Mountain Va, 325 East H Street, Iron Mountain, MI 49801 | 2013-04-09 |
| 1902196702 | Daniel John Fornetti | Dentist | 100 S. Stephenson Ave., Iron Mountain, MI 49801 | 2011-04-13 |
| 1871815613 | Colleen Ann Sleik | Physical Therapist | Bellin Health Physical Therapy Iron Moutain, 440 Woodward Ave, Iron Mountain, MI 49801 | 2010-02-21 |
| 1679714083 | Great Lakes Recovery Centers, Inc. | Clinic/Center | 1401 N. 26th Street, Suite 109, Escanaba, MI 49801 | 2009-03-13 |
| 1831349539 | Amanda Jane Petti | Dietitian, Registered | 300 E H Street, Nutrition & Food Service, Iron Mountain, MI 49801 | 2008-09-30 |
| 1891946521 | Riki Rouse | Hearing Instrument Specialist | W8065 S Us Hwy 2/141, Iron Mountain, MI 49801 | 2008-09-30 |
| 1366690612 | Greenlund Enterpries, Inc | Hearing Aid Equipment | W8065 S. Us High 2/141, Suite #13, Iron Mountain, MI 49801 | 2008-08-28 |
| Find all providers in zip 49801 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891012621 | John F Selden | Internal Medicine | 1721 S Stephenson Ave, Iron Mountain, MI 49801-3637 | 2010-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003440439 | Nephrocare Dialysis, LLC | Internal Medicine | Garden City Hosptial, 6245 Inkster Road, Garden City, MI 48135 | 2020-02-25 |
| 1740823459 | Critical Care Nephrology, PC | Internal Medicine | 333 E Parent Ave, Royal Oak, MI 48067-3748 | 2019-10-25 |
| 1568948537 | Amanda Thelen | Internal Medicine | 405 W Greenlawn Ave Ste 230, Lansing, MI 48910-0812 | 2018-07-12 |
| 1023507357 | James Francis Murphy | Internal Medicine | Hope Medical Clinic 518 Harriet St., Ypsilanti, MI 48197-0311 | 2018-05-02 |
| 1457865354 | Aaa Home Visiting Pllc | Internal Medicine | 1502 Fort St, Detroit, MI 48216 | 2017-11-30 |
| 1982129805 | Abhay Mishra | Internal Medicine | 4160 John R St Ste 908, Detroit, MI 48201-2017 | 2017-08-11 |
| 1326586959 | Alhaji Consultant Pllc | Internal Medicine | 29201 Chateau Ct, Farmington Hills, MI 48334-4112 | 2017-02-02 |
| 1033669445 | T-beyene Hypertension & Kidney Care Plc | Internal Medicine | 4160 John R Ste 1011, Harper Professional Building, Detroit, MI 48201 | 2016-10-10 |
| 1285085860 | Omer Yousif | Internal Medicine | 29829 Telegraph Rd Ste 202, Southfield, MI 48034-7656 | 2016-06-24 |
| 1710378377 | Rawm Vascular Access, Pllc | Internal Medicine | 1540 36th Street. Sw, Wyoming, MI 49509 | 2015-02-17 |
| Find all providers with the same taxonomy | ||||
| City | IRON MOUNTAIN |
| Zip Code | 49801 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.