MEDICARE: DR. CHRISTINA MARIE FLANNELLY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	39940	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003866211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA MARIE FLANNELLY MD

Provider Business Mailing Address
First Line	:	PO BOX 96860
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28296-6860
Country	:	US
Telephone Number	:	919-896-7066
Fax Number	:	919-896-7067

Provider Business Practice Location Address
First Line	:	8300 HEALTH PARK STE 213
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-4731
Country	:	US
Telephone Number	:	919-896-7066
Fax Number	:	919-896-7067

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	06/03/2025

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