Provider Demographics
NPI:1356441877
Name:FLEISCHHACKER, MICHAEL E (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:FLEISCHHACKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:FLEISCHHACKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1654 DIFFLEY RD
Mailing Address - Street 2:STE 100
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122
Mailing Address - Country:US
Mailing Address - Phone:651-456-8670
Mailing Address - Fax:651-641-3920
Practice Address - Street 1:1654 DIFFLEY RD
Practice Address - Street 2:STUITE 100
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2237
Practice Address - Country:US
Practice Address - Phone:651-203-9022
Practice Address - Fax:651-641-3904
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN280428000Medicaid
MNU59417Medicare UPIN
MN350002015Medicare ID - Type Unspecified