Provider Demographics
NPI:1467429175
Name:FLOM, ANDREA JEANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:JEANNE
Last Name:FLOM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 NICOLLET MALL
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2500
Mailing Address - Country:US
Mailing Address - Phone:612-333-2503
Mailing Address - Fax:
Practice Address - Street 1:801 NICOLLET MALL
Practice Address - Street 2:SUITE 400
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2500
Practice Address - Country:US
Practice Address - Phone:612-333-2503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN33517207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN110639D686OtherU-CARE
MNFP9041001068OtherPREFERRED ONE
MN0719875OtherMEDICA CHOICE
MN160011189OtherRAILROAD MEDICARE
MN26395OtherAMERICA'S PPO
MN27902FLOtherBLUE CROSS BLUE SHIELD
1467429175OtherNPI
WI31796100Medicaid
MN0700065OtherMEDICA DUAL/MEDICARE MA
MN538800700Medicaid
MNA005OtherTRICARE WEST/CHAMPUS
MNHP13295OtherHEALTH PARTNERS
MN538800700Medicaid
MN0719875OtherMEDICA CHOICE