Provider Demographics
NPI:1750307443
Name:FLOREK, MICHAEL H (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:FLOREK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:850 N CENTER AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-1682
Mailing Address - Country:US
Mailing Address - Phone:989-731-7708
Mailing Address - Fax:989-731-7929
Practice Address - Street 1:3696 S STRAITS HWY
Practice Address - Street 2:
Practice Address - City:INDIAN RIVER
Practice Address - State:MI
Practice Address - Zip Code:49749-5136
Practice Address - Country:US
Practice Address - Phone:231-238-0581
Practice Address - Fax:231-238-0586
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101013965207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4296010Medicaid
MI4296010Medicaid
MIOF96004Medicare PIN
A66000052Medicare ID - Type Unspecified