Provider Demographics
NPI:1124238654
Name:DOE, ALICE FLORINA (MD)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:FLORINA
Last Name:DOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALICE
Other - Middle Name:FLORINA
Other - Last Name:STROE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1535 GULL RD STE 130
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1659
Mailing Address - Country:US
Mailing Address - Phone:269-345-1161
Mailing Address - Fax:
Practice Address - Street 1:1717 SHAFFER ST STE 124
Practice Address - Street 2:BORGESS HEALTH
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1629
Practice Address - Country:US
Practice Address - Phone:269-226-5967
Practice Address - Fax:269-552-0284
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301083451207R00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1124238654OtherNPI
MI1407827900OtherNPI NUMBER FOR THE GROUP PRACTICE (SLEEP DIAGNOSTICS OF MICHIGAN PC)
MI1124238654Medicaid
MI700F510150OtherBLUE CROSS
MI1124238654Medicaid