Healthcare Provider Details

I. General information

NPI: 1689678336
Provider Name (Legal Business Name): MATTHEW K FLYNN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 10/19/2025
Certification Date: 10/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5603 DURALEIGH RD STE 111
RALEIGH NC
27612-2688
US

IV. Provider business mailing address

5603 DURALEIGH RD STE 111
RALEIGH NC
27612-2688
US

V. Phone/Fax

Practice location:
  • Phone: 919-791-0840
  • Fax: 919-791-0911
Mailing address:
  • Phone: 919-791-0840
  • Fax: 919-791-0911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number200200111
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number200200111
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: