Provider Demographics
NPI:1497770770
Name:FLES, ROBERT J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:FLES
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:605 W WESTERN AVE
Mailing Address - Street 2:RADIOLOGY MUSKEGON PLC
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49440-1080
Mailing Address - Country:US
Mailing Address - Phone:231-672-3955
Mailing Address - Fax:231-672-6716
Practice Address - Street 1:1500 E SHERMAN BLVD
Practice Address - Street 2:MERCY GENERAL HOSPITAL - RADIOLOGY DEPARTMENT
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1849
Practice Address - Country:US
Practice Address - Phone:231-672-3955
Practice Address - Fax:231-672-6716
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2012-04-10
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Provider Licenses
StateLicense IDTaxonomies
MI430100458172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIRF045817OtherLICENSE
MI1432074Medicaid
MIRF045817OtherLICENSE
B44387Medicare UPIN
0F46000031Medicare PIN
MI1432074Medicaid