Healthcare Provider Details
I. General information
NPI: 1982658456
Provider Name (Legal Business Name): FLINT GASTROENTEROLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2006
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8275 HOLLY RD STE 2
GRAND BLANC MI
48439-2442
US
IV. Provider business mailing address
3495 S CENTER RD
BURTON MI
48519-1455
US
V. Phone/Fax
- Phone: 810-603-8400
- Fax: 810-603-8410
- Phone:
- Fax: 810-743-1099
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEREK
KORTE
Title or Position: PRESIDENT
Credential: D.O.
Phone: 810-603-8400