Provider Demographics
NPI:1942233754
Name:FURNEY, KYM ORSETTI (MD)
Entity Type:Individual
Prefix:DR
First Name:KYM
Middle Name:ORSETTI
Last Name:FURNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 FAIRVIEW RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3113
Mailing Address - Country:US
Mailing Address - Phone:704-495-6334
Mailing Address - Fax:
Practice Address - Street 1:10635 PARK RD STE I
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8408
Practice Address - Country:US
Practice Address - Phone:704-495-6025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC82286207R00000X
NC200200758207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1942233754Medicaid
NC89131XYMedicaid
NC2007885Medicare PIN
NC89131XYMedicaid
NC2007885CMedicare PIN
NCG06235Medicare UPIN