Healthcare Provider Details

I. General information

NPI: 1861489429
Provider Name (Legal Business Name): RAINNA MARIE FURNARI-BRAZIL D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20905 GREENFIELD RD STE 200
SOUTHFIELD MI
48075-5346
US

IV. Provider business mailing address

20905 GREENFIELD RD STE 200
SOUTHFIELD MI
48075-5346
US

V. Phone/Fax

Practice location:
  • Phone: 248-327-7212
  • Fax:
Mailing address:
  • Phone: 248-327-7212
  • Fax: 248-728-4195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101012438
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number5101012438
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: