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General NPI Number Information
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NPI Number | 1710980586
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE ASSOCIATES OF FLINT P.C.
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 07/25/2011
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Provider Practice Location Address
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Address Line | G5607 W. BRISTOL RD.
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City | FLINT
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State | MI
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Zip | 48507
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Country | US
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Telephone | 810-230-0120
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Fax | 810-230-6733
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Provider Business Mailing Address
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Address Line | 3499 S LINDEN RD
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City | FLINT
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State | MI
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Zip | 48507-3022
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Country | US
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Telephone | 810-230-0120
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Fax | 810-230-6733
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MRS. LEDEAN CHAMPINE
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Credential |
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Telephone | 810-230-0120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | EC023744
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License Number State | MI
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