Individual
ANDREW THOMAS FLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-3241
(765) 281-6567
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01075119A
IN
207P00000X
Emergency Medicine Physician
4301100862
MI
390200000X
Student in an Organized Health Care Education/Training Program
4301100862
MI
Other
Enumeration date
05/25/2012
Last updated
08/15/2022
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