Provider Demographics
NPI:1205819422
Name:FLORA, DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:
Last Name:FLORA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3481
Mailing Address - Country:US
Mailing Address - Phone:989-791-1110
Mailing Address - Fax:989-791-1194
Practice Address - Street 1:6320 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3481
Practice Address - Country:US
Practice Address - Phone:989-791-1110
Practice Address - Fax:989-791-1194
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005133111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950G35000OtherBLUE CROSS/BLUE SHIELD
MI350014271OtherMEDICARE RAILROAD
MI0G950074952Medicare ID - Type Unspecified
MI350014271OtherMEDICARE RAILROAD