Provider Demographics
NPI:1447710124
Name:FURMANEK, JONATHAN (DPM)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:FURMANEK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 FRANKLIN SQUARE DR STE 214
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3934
Mailing Address - Country:US
Mailing Address - Phone:443-777-7631
Mailing Address - Fax:443-777-8667
Practice Address - Street 1:9105 FRANKLIN SQUARE DR STE 214
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3934
Practice Address - Country:US
Practice Address - Phone:443-777-7631
Practice Address - Fax:443-777-8667
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4437213ES0103X
390200000X
MD01770213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty