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FLYNN DERMATOLOGY PA NPI 1588674568


NPI Information

NPI: 1588674568
Provider Name: FLYNN DERMATOLOGY PA

Doing Business As: FAMILY DERMATOLOGY

Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 34D1013232

Address:
5603 DURALEIGH RD
SUITE 111
RALEIGH, NC
ZIP 27612
Phone: (919) 791-0840
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FLYNN DERMATOLOGY PA is a specialist in Raleigh, NC. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. FLYNN DERMATOLOGY PA NPI is 1588674568. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Family Dermatology.

The provider's business location address is:

5603 DURALEIGH RD
SUITE 111
RALEIGH, NC
ZIP 27612-688
Phone: (919) 791-0840
Fax: (919) 791-0911

The provider's authorized official is Matthew K Flynn .
The authorized official title is President and has the following contact phone number (919) 791-0840.

The CLIA number assigned to this NPI record is 34D1013232 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/9/2006 and was last updated on 8/24/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistNORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12333971MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINAGRP MEDICARE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.