Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 35129623 | OH |
N | 207QS0010X | Family Doctor - Sports Medicine | MD32681 | AL |
NPI | 1255514394 |
---|---|
Provider Name | Dr. Robert Brian Flannery |
First Address | Highland Hills, OH 44122-7250 |
Second Address | Cleveland, OH 44106-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2007 |
Last Update Date | 01/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102G704091 | (02) | AL |