Provider Demographics
NPI:1699750117
Name:AUSTIN, MOLLY M (MD)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:M
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4256 S LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2978
Mailing Address - Country:US
Mailing Address - Phone:810-733-8890
Mailing Address - Fax:810-733-6631
Practice Address - Street 1:4256 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2978
Practice Address - Country:US
Practice Address - Phone:810-733-8890
Practice Address - Fax:810-733-6631
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074085207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H63059Medicare UPIN
OP22110Medicare ID - Type Unspecified