Provider Demographics
NPI:1639383110
Name:FLINT CHILDREN'S CENTER, PC
Entity Type:Organization
Organization Name:FLINT CHILDREN'S CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:810-733-0400
Mailing Address - Street 1:5205 NORKO DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3027
Mailing Address - Country:US
Mailing Address - Phone:810-733-0400
Mailing Address - Fax:810-733-8638
Practice Address - Street 1:5205 NORKO DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3027
Practice Address - Country:US
Practice Address - Phone:810-733-0400
Practice Address - Fax:810-733-8638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMH051513208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1001811OtherMCLAREN HEALTH PLAN
MI2964982Medicaid
MI4821236Medicaid
MI0994720OtherHEALTH PLUS
MI35025009012OtherBLUE CROSS BLUE SHIELD
MIP62874OtherBLUE CARE NETWORK
MIC5505OtherMCARE
MI021022OtherCHILDREN'S CHOICE OF MI
MI3502509182OtherBLUE CROSS BLUE SHIELD
MI14695OtherMCARE
MI3502500912OtherHEALTH PLUS
MI3S509182OtherHEALTH PLUS
MIG01761OtherBLUE CARE NETWORK GROUP
MI1007181OtherMCLAREN HEALTH PLAN
MIC3740OtherMCARE
MI4106643Medicaid
MIP79625OtherBLUE CARE NETWORK
MI020994OtherCHILDREN'S CHOICE OF MI
MI1001841OtherMCLAREN HEALTH PLAN
MIP59531OtherBLUE CARE NETWORK