Healthcare Provider Details

I. General information

NPI: 1780673814
Provider Name (Legal Business Name): EDWARD R FLOTTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 DAUPHIN ST BUILDING A
MOBILE AL
36606-4060
US

IV. Provider business mailing address

3280 DAUPHIN ST BUILDING A
MOBILE AL
36606-4060
US

V. Phone/Fax

Practice location:
  • Phone: 251-450-3700
  • Fax: 251-662-3819
Mailing address:
  • Phone: 251-450-3700
  • Fax: 251-662-3819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number26744
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: