Basic Information
| Provider Information | |||||||||
| NPI: | 1467429175 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLOM | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | JEANNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 NICOLLET MALL | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554022500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123332503 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 801 NICOLLET MALL | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554022500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123332503 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2006 | ||||||||
| LastUpdateDate: | 04/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 33517 | MN | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 110639D686 | 01 | MN | U-CARE | OTHER | FP9041001068 | 01 | MN | PREFERRED ONE | OTHER | 0719875 | 01 | MN | MEDICA CHOICE | OTHER | 160011189 | 01 | MN | RAILROAD MEDICARE | OTHER | 26395 | 01 | MN | AMERICA'S PPO | OTHER | 27902FL | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | 1467429175 | 01 | NPI | OTHER | 31796100 | 05 | WI | MEDICAID | 0700065 | 01 | MN | MEDICA DUAL/MEDICARE MA | OTHER | 538800700 | 05 | MN | MEDICAID | A005 | 01 | MN | TRICARE WEST/CHAMPUS | OTHER | HP13295 | 01 | MN | HEALTH PARTNERS | OTHER |