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Individual

LISA M FLYNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4160 JOHN R, SUITE 615, DETROIT, MI 48201-2020
(313) 745-4195
(313) 993-8669
Mailing address
1420 STEPHENSON HWY, SUITE 400-CREDENTIALING, TROY, MI 48083-1189
(248) 581-5974
(248) 581-5640

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301061622
MI
2086S0129X
Vascular Surgery Physician
Primary
4301061622
MI

Other

Enumeration date
08/12/2005
Last updated
12/27/2013
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