Healthcare Provider Details

I. General information

NPI: 1033191382
Provider Name (Legal Business Name): RENEE FLANNAGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 10/05/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 FEDERAL ST SUITE B100
PITTSBURGH PA
15212-4769
US

IV. Provider business mailing address

1307 FEDERAL ST SUITE B100
PITTSBURGH PA
15212-4769
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-8900
  • Fax: 412-359-8900
Mailing address:
  • Phone: 412-359-8900
  • Fax: 412-359-8900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD071998L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: