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1154302610

NPI Code Detail

MEDICARE: TIMOTHY CORCORAN FLYNN M.D.

MEDICARE: TIMOTHY CORCORAN FLYNN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	29569	NC
2	207ND0101X	MOHS-Micrographic Surgery Physician	29569	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22635	OTHER	NC	DOCTORS HEALTH PLAN
2	2549406	OTHER		AETNA HMO
3	4230459	OTHER		AETNA PPO
4	42294	OTHER		PARTNERS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	3108348002	OTHER	NC	CIGNA HEALTHCARE HMO
7	562070218F	OTHER	NC	CIGNA HEALTHCARE
8	0357057	OTHER		UNITED HEALTHCARE
9	128G2	OTHER	NC	BCBS
10	290914	OTHER		MAMSI/ALLIANCE
11	A6811	OTHER		MEDCOST

General Provider Information

NPI Number	:	1154302610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY CORCORAN FLYNN M.D.

Provider Business Mailing Address
First Line	:	200 WELLESLEY TRADE LN
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27519-5576
Country	:	US
Telephone Number	:	919-363-7546
Fax Number	:	919-363-3616

Provider Business Practice Location Address
First Line	:	200 WELLESLEY TRADE LN
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27519-5576
Country	:	US
Telephone Number	:	919-363-7546
Fax Number	:	919-363-3616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	09/29/2020

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Directions to “ TIMOTHY CORCORAN FLYNN M.D.” Practice Location

Language	Start Address	Practice Location

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