MEDICARE: INTERNAL MEDICINE ASSOCIATES OF FLINT P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	EC023744	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CB7526	OTHER	MI	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1710980586	OTHER	MI	NPI
2	110B56381	OTHER	MI	BCBS
3	5173988	OTHER	MI	CIGNA

General Provider Information

NPI Number	:	1710980586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNAL MEDICINE ASSOCIATES OF FLINT P.C.

Provider Business Mailing Address
First Line	:	3499 S LINDEN RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-3022
Country	:	US
Telephone Number	:	810-230-0120
Fax Number	:	810-230-6733

Provider Business Practice Location Address
First Line	:	G5607 W. BRISTOL RD.
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507
Country	:	US
Telephone Number	:	810-230-0120
Fax Number	:	810-230-6733

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	MRS. LEDEAN CHAMPINE
Credential	:
Telephone Number	:	810-230-0120

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/25/2011

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Directions to “INTERNAL MEDICINE ASSOCIATES OF FLINT P.C. ” Practice Location

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