Provider Demographics
NPI:1952321390
Name:FURMAN, DOUGLAS A (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:A
Last Name:FURMAN
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:PO BOX 607
Mailing Address - Street 2:7037 WEST M-68 HWY
Mailing Address - City:INDIAN RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49749
Mailing Address - Country:US
Mailing Address - Phone:231-238-9386
Mailing Address - Fax:231-238-6895
Practice Address - Street 1:7037 WEST M-68 HWY
Practice Address - Street 2:
Practice Address - City:INDIAN RIVER
Practice Address - State:MI
Practice Address - Zip Code:49749
Practice Address - Country:US
Practice Address - Phone:231-238-9386
Practice Address - Fax:231-238-6895
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDF033946207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI411487910Medicaid
MI081627852OtherBCBS
B47258Medicare UPIN
MIOM81640Medicare ID - Type Unspecified