Basic Information
Provider Information
NPI: 1427199439
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLAMMER
FirstName: KRISTIN
MiddleName: MICHELLE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 301 HOSPITAL DR
Address2:  
City: GLEN BURNIE
State: MD
PostalCode: 210615803
CountryCode: US
TelephoneNumber: 4107874594
FaxNumber: 4107874846
Practice Location
Address1: 300 HOSPITAL DR
Address2: SUITE 119
City: GLEN BURNIE
State: MD
PostalCode: 210616902
CountryCode: US
TelephoneNumber: 4107874940
FaxNumber: 4107874941
Other Information
ProviderEnumerationDate: 02/11/2007
LastUpdateDate: 10/16/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101XD0066957MDY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

No ID Information.


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