Provider Demographics
NPI:1902887946
Name:FURDA, DAVID L (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:FURDA
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 1:1200 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2735
Mailing Address - Country:US
Mailing Address - Phone:320-252-5131
Mailing Address - Fax:320-240-2118
Practice Address - Street 1:1200 6TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2735
Practice Address - Country:US
Practice Address - Phone:320-252-5131
Practice Address - Fax:320-240-2118
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN22084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
101519OtherUCARE
33A91FUOtherBLUE CROSS BLUE SHIELD
HP22756OtherHEALTH PARTNERS
051999OtherMMSI
0405564OtherMEDICA HEALTH PLANS
182385000OtherMEDICAL ASSISTANCE
1001263OtherPREFERRED ONE
2114051OtherFIRST HEALTH PLAN
21962OtherARAZ GROUP AMERICAS PPO
110129729Medicare ID - Type UnspecifiedRR MEDICARE
0405564OtherMEDICA HEALTH PLANS
182385000OtherMEDICAL ASSISTANCE
33A91FUOtherBLUE CROSS BLUE SHIELD