Doctor Name: | MR. DUSTIN D. FLANNERY |
NPI Number: | 1073802591 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | C20010658 |
Business Practice Address: | 3401 Civic Center Blvd Division Of Neonatology Philadelphia, PA - 191044319 |
Business Phone Number: | 2155904393 |
Business Fax Number: | |
Mailing Address: | 3401 Civic Center Blvd, Division Of Neonatology PHILADELPHIA |
State: | PA |
Postal Code: | 191044319 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/05/2011 |
NPI Last Update Date: | 08/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C20010658 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | DE |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |