Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2301005133 | MI |
NPI | 1205819422 |
---|---|
Provider Name | Dr. Dean Flora |
First Address | Saginaw, MI 48603-3481 |
Second Address | Saginaw, MI 48603-3481 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 21/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
350014271 | MEDICARE RAILROAD (01) | MI |
950G35000 | BLUE CROSS/BLUE SHIELD (01) | MI |
T33547 | (02) | MI |