Provider Demographics
NPI:1639245103
Name:ALAN FLIGIEL MD PLC
Entity type:Organization
Organization Name:ALAN FLIGIEL MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLIGIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-676-3376
Mailing Address - Street 1:1650 FORT STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2041
Mailing Address - Country:US
Mailing Address - Phone:734-676-3376
Mailing Address - Fax:734-676-7162
Practice Address - Street 1:1650 FORT STREET
Practice Address - Street 2:SUITE B
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2041
Practice Address - Country:US
Practice Address - Phone:734-676-3376
Practice Address - Fax:734-676-7162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301045623207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1919015Medicaid
MI1919015Medicaid
MI0822683Medicare ID - Type Unspecified