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General NPI Number Information
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NPI Number | 1740798271
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Entity Type | Organization
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Legal Business Name | MICHAEL L. FLANNERY
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 01/18/2018
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Provider Practice Location Address
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Address Line | 34589 SUMMERS ST
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City | LIVONIA
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State | MI
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Zip | 48154-5327
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Country | US
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Telephone | 313-236-0008
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Fax |
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Provider Business Mailing Address
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Address Line | 34589 SUMMERS ST
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City | LIVONIA
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State | MI
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Zip | 48154-5327
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL FLANNERY
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Credential | MSW
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Telephone | 313-236-0008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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