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NPI Code Detail

MEDICARE: RUSSELL KINSHUN FUNG M.D.

MEDICARE: RUSSELL KINSHUN FUNG M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RE0101XEndocrinology, Diabetes & Metabolism Physician88594GA

General Provider Information

NPI Number : 1497118285
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUSSELL KINSHUN FUNG M.D.
Provider Business Mailing Address
First Line : PO BOX 1060
Second Line :
City : OAKWOOD
State : GA
Zip : 30566-0018
Country : US
Telephone Number : 770-718-1122
Fax Number :
Provider Business Practice Location Address
First Line : 725 JESSE JEWELL PKWY SE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3834
Country : US
Telephone Number : 770-297-2238
Fax Number : 770-533-6578
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2016
Last Update Date : 02/04/2026

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