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General NPI Number Information
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NPI Number | 1811186133
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Entity Type | Individual
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Provider Name | MATTHEW ROSS FLANAGAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 100 MEDICAL BLVD
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City | CANONSBURG
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State | PA
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Zip | 15317-9762
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Country | US
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Telephone | 724-873-5955
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Fax | 724-873-5907
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Provider Business Mailing Address
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Address Line | 100 MEDICAL BLVD
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City | CANONSBURG
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State | PA
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Zip | 15317-9762
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Country | US
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Telephone | 724-873-5955
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Fax | 724-873-5907
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number | OS014703
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License Number State | PA
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