Provider Demographics
NPI:1366443590
Name:FLAREY, ANTHONY GUY (DO)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:GUY
Last Name:FLAREY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2146 SOUTHGATE PARKWAY CAMBRIDGE VA CLINIC
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725
Mailing Address - Country:US
Mailing Address - Phone:740-432-1963
Mailing Address - Fax:740-435-0713
Practice Address - Street 1:2146 SOUTHGATE PARKWAY CAMBRIDGE VA CLINIC
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725
Practice Address - Country:US
Practice Address - Phone:740-432-1963
Practice Address - Fax:740-435-0713
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-007149207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2155877Medicaid
H08204Medicare UPIN
PO0433217Medicare PIN
OH0896953Medicare PIN