Healthcare Provider Details

I. General information

NPI: 1588125074
Provider Name (Legal Business Name): MICHAEL SCOTT FLANCHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N 92ND ST STE 730
MILWAUKEE WI
53226-4875
US

IV. Provider business mailing address

215 WASHINGTON ST
GRAFTON WI
53024-1700
US

V. Phone/Fax

Practice location:
  • Phone: 414-266-6800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7415320
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: