Provider Demographics
| NPI: | 1275807372 |
|---|---|
| Name: | MCLAREN FLINT |
| Entity type: | Organization |
| Organization Name: | MCLAREN FLINT |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CFO |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | FRED |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | KORTE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 810-342-2000 |
| Mailing Address - Street 1: | 401 S BALLENGER HWY |
| Mailing Address - Street 2: | |
| Mailing Address - City: | FLINT |
| Mailing Address - State: | MI |
| Mailing Address - Zip Code: | 48532-3638 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 810-342-2000 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 401 S BALLENGER HWY |
| Practice Address - Street 2: | |
| Practice Address - City: | FLINT |
| Practice Address - State: | MI |
| Practice Address - Zip Code: | 48532 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 810-342-2000 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2012-03-07 |
| Last Update Date: | 2018-08-09 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 208600000X, 207P00000X, 207Q00000X, 207R00000X, 207RH0003X, 207V00000X, 207X00000X, 208000000X, 2083X0100X, 363A00000X, 363AM0700X, 363L00000X, 367A00000X, 208D00000X | ||
| MI | 2085R0202X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 2083X0100X | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine | Group - Multi-Specialty |
| No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Multi-Specialty |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
| No | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | Group - Multi-Specialty |