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General NPI Number Information
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NPI Number | 1063749547
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Entity Type | Organization
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Legal Business Name | FLYNN MEDICAL GROUP
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 9701 NEW CHURCH RD
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City | DAMASCUS
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State | MD
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Zip | 20872-2000
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Country | US
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Telephone | 240-355-1040
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Fax |
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Provider Business Mailing Address
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Address Line | 3470 OLNEY LAYTONSVILLE RD
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City | OLNEY
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State | MD
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Zip | 20832-1734
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. GAWIN FLYNN
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Credential | M.D
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Telephone | 240-355-1040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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