Provider Demographics
NPI:1285681486
Name:FLIGIEL, ALAN (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:FLIGIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 FORT STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2041
Mailing Address - Country:US
Mailing Address - Phone:734-676-3376
Mailing Address - Fax:734-676-7162
Practice Address - Street 1:1650 FORT STREET
Practice Address - Street 2:SUITE B
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2041
Practice Address - Country:US
Practice Address - Phone:734-676-3376
Practice Address - Fax:734-676-7162
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301045623207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1919015Medicaid
MI1919015Medicaid
A44029Medicare UPIN