Provider Demographics
NPI: | 1275807372 |
---|---|
Name: | MCLAREN FLINT |
Entity type: | Organization |
Organization Name: | MCLAREN FLINT |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | FRED |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KORTE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 810-342-2000 |
Mailing Address - Street 1: | 401 S BALLENGER HWY |
Mailing Address - Street 2: | |
Mailing Address - City: | FLINT |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48532-3638 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 810-342-2000 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 401 S BALLENGER HWY |
Practice Address - Street 2: | |
Practice Address - City: | FLINT |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48532 |
Practice Address - Country: | US |
Practice Address - Phone: | 810-342-2000 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-03-07 |
Last Update Date: | 2018-08-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
207P00000X, 207Q00000X, 207R00000X, 207RH0003X, 207V00000X, 207X00000X, 208000000X, 2083X0100X, 208600000X, 208D00000X, 363A00000X, 363AM0700X, 363L00000X, 367A00000X | ||
MI | 2085R0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 2083X0100X | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine | Group - Multi-Specialty |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Multi-Specialty |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | Group - Multi-Specialty |