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General NPI Number Information
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NPI Number | 1497770770
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Entity Type | Individual
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Provider Name | ROBERT J FLES JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 04/10/2012
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Provider Practice Location Address
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Address Line | 1500 E SHERMAN BLVD MERCY GENERAL HOSPITAL - RADIOLOGY DEPARTMENT
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City | MUSKEGON
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State | MI
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Zip | 49444-1849
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Country | US
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Telephone | 231-672-3955
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Fax | 231-672-6716
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Provider Business Mailing Address
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Address Line | 605 W WESTERN AVE RADIOLOGY MUSKEGON PLC
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City | MUSKEGON
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State | MI
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Zip | 49440-1080
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Country | US
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Telephone | 231-672-3955
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Fax | 231-672-6716
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 43010045817
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License Number State | MI
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