Provider Demographics
NPI:1770632945
Name:DEAN, FLORA ANN (MD)
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:ANN
Last Name:DEAN
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 1:27207 LAHSER RD STE 250
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-2168
Mailing Address - Country:US
Mailing Address - Phone:248-809-2853
Mailing Address - Fax:248-809-9921
Practice Address - Street 1:27207 LAHSER RD STE 250
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-2168
Practice Address - Country:US
Practice Address - Phone:248-809-2853
Practice Address - Fax:248-809-9921
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080335174400000X, 208100000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MII70611OtherUPIN
MI4301080335OtherLICENSE NUMBER
MI5315025734OtherCONTROLLED SUBSTANCE LICENSE NUMBER
MI1326213315OtherNPI UNDER REHAB ALLIANCE, PC
MI1770632945OtherNPI
MI56800001OtherPTAN
MI1326213315OtherNPI UNDER REHAB ALLIANCE, PC
MII70611OtherUPIN