Provider Demographics
NPI:1295706414
Name:FRANCO-IMPERIAL, ALICIA JOSEFINA (MD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:JOSEFINA
Last Name:FRANCO-IMPERIAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G 2241 S LINDEN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532
Mailing Address - Country:US
Mailing Address - Phone:810-733-9470
Mailing Address - Fax:810-733-9490
Practice Address - Street 1:G 2241 S LINDEN RD
Practice Address - Street 2:SUITE B
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532
Practice Address - Country:US
Practice Address - Phone:810-733-9470
Practice Address - Fax:810-733-9490
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAF4301043430208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4470060Medicaid
ON69010Medicare ID - Type Unspecified
MI4470060Medicaid