Provider Demographics
NPI:1346020047
Name:FUNTE, LIAM EIRIK (MD)
Entity Type:Individual
Prefix:
First Name:LIAM
Middle Name:EIRIK
Last Name:FUNTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HOSPITAL STREET
Mailing Address - Street 2:OCME
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330
Mailing Address - Country:US
Mailing Address - Phone:207-624-7185
Mailing Address - Fax:
Practice Address - Street 1:30 HOSPITAL STREET
Practice Address - Street 2:OCME
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-0433
Practice Address - Country:US
Practice Address - Phone:207-624-7185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD21990207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology