Provider Demographics
NPI:1457339244
Name:FLECK, MICHAEL F (OB)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:F
Last Name:FLECK
Suffix:
Gender:M
Credentials:OB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1066 CHELSEA AVE
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-1202
Mailing Address - Country:US
Mailing Address - Phone:419-599-9146
Mailing Address - Fax:419-599-4191
Practice Address - Street 1:1066 CHELSEA AVE
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-1202
Practice Address - Country:US
Practice Address - Phone:419-599-9146
Practice Address - Fax:419-599-4191
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4363167152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0276062Medicaid
OHMI9345651Medicare ID - Type Unspecified