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NPI Code Detail

MEDICARE: DR. STEPHEN THOMAS FLANAGAN D.C.

MEDICARE:  DR. STEPHEN THOMAS FLANAGAN  D.C.
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
1111N00000XChiropractor812MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y35579OTHERMABLUECROSSBLUESHIELD MA

General Provider Information

NPI Number : 1720066160
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN THOMAS FLANAGAN D.C.
Provider Business Mailing Address
First Line : 2075 CENTRE ST
Second Line :
City : WEST ROXBURY
State : MA
Zip : 02132-3313
Country : US
Telephone Number : 617-323-1141
Fax Number : 617-323-0808
Provider Business Practice Location Address
First Line : 2075 CENTRE ST
Second Line :
City : WEST ROXBURY
State : MA
Zip : 02132-3313
Country : US
Telephone Number : 617-323-1141
Fax Number : 617-323-0808
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2006
Last Update Date : 07/08/2007

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