Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2061 | GA |
N | 111NI0900X | Internist | 2061 | GA |
Y | 207RH0003X | Hematology & Oncology | 0101251300 | VA |
NPI | 1023293701 |
---|---|
Provider Name | Renee Elizabeth Funches |
First Address | Rockville, MD 20852-4908 |
Second Address | Fairfax, VA 22033-3952 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2007 |
Last Update Date | 03/08/2021 |