Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 47185 | CO |
NPI | 1124070602 |
---|---|
Provider Name | Brendan Michael Flynn |
First Address | Winchester, VA 22601-3876 |
Second Address | Winchester, VA 22601-3876 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 26/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
68773331 | (05) | CO |