Provider Demographics
NPI:1497867311
Name:FLAIM, ANTHONY R (DO)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:R
Last Name:FLAIM
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:PO BOX 1650
Mailing Address - Street 2:FAMILY HEALTHCARE ASSOCIATES INC
Mailing Address - City:PINEVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:24874-1650
Mailing Address - Country:US
Mailing Address - Phone:304-732-6735
Mailing Address - Fax:304-732-9218
Practice Address - Street 1:COOK PKWY
Practice Address - Street 2:FAMILY HEALTHCARE ASSOCIATES INC
Practice Address - City:OCEANA
Practice Address - State:WV
Practice Address - Zip Code:24870-1710
Practice Address - Country:US
Practice Address - Phone:304-682-8238
Practice Address - Fax:304-682-4068
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV802207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0049790-000Medicaid
WV0049790-000Medicaid
0894811Medicare ID - Type UnspecifiedOC
0894813Medicare ID - Type UnspecifiedMUL
WVE78950Medicare UPIN
0894815Medicare ID - Type UnspecifiedGIL
0894812Medicare PIN