Provider Demographics
NPI:1881271955
Name:MA, FLORA YAN
Entity type:Individual
Prefix:
First Name:FLORA
Middle Name:YAN
Last Name:MA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZHI XIN
Other - Middle Name:
Other - Last Name:MA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6244 LINCOLNSHIRE CT SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7109
Mailing Address - Country:US
Mailing Address - Phone:586-850-1407
Mailing Address - Fax:
Practice Address - Street 1:412 CENTURY LN
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4285
Practice Address - Country:US
Practice Address - Phone:616-430-6909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist