Provider Demographics
NPI:1891789004
Name:FLAM, MARSHALL STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:STANLEY
Last Name:FLAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7130 N MILLBROOK AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3347
Mailing Address - Country:US
Mailing Address - Phone:559-447-4949
Mailing Address - Fax:559-447-4925
Practice Address - Street 1:7130 N MILLBROOK AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3347
Practice Address - Country:US
Practice Address - Phone:559-447-4949
Practice Address - Fax:559-447-4925
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG20870207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ75882ZMedicaid
A41098Medicare UPIN
CAZZZ75882ZMedicaid