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General NPI Number Information
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NPI Number | 1417234238
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Entity Type | Organization
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Legal Business Name | ANGELIA M FLANAGAN MD PA
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 3400 EXECUTIVE DR SUITE 101
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City | RALEIGH
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State | NC
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Zip | 27609-7476
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Country | US
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Telephone | 919-865-2290
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Fax | 919-865-2291
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Provider Business Mailing Address
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Address Line | 3400 EXECUTIVE DR SUITE 101
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City | RALEIGH
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State | NC
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Zip | 27609-7476
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Country | US
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Telephone | 919-865-2290
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Fax | 919-865-2291
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANGELIA M FLANAGAN
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Credential | MD
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Telephone | 919-865-2290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36477
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License Number State | NC
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