Provider Demographics
NPI:1861489429
Name:FURNARI-BRAZIL, RAINNA MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:RAINNA
Middle Name:MARIE
Last Name:FURNARI-BRAZIL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20905 GREENFIELD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5346
Mailing Address - Country:US
Mailing Address - Phone:248-327-7212
Mailing Address - Fax:248-728-4195
Practice Address - Street 1:20905 GREENFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5346
Practice Address - Country:US
Practice Address - Phone:248-327-7212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012438208VP0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4242411Medicaid
MI0Q26334034Medicare ID - Type Unspecified
MI4242411Medicaid