Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD25049 | NE |
Y | 2080P0202X | Pediatric Cardiologist | MD25049 | NE |
NPI | 1235399585 |
---|---|
Provider Name | Ryan Flanagan |
First Address | Honolulu, HI 96859 |
Second Address | Tripler Amc, HI 96859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 11/09/2021 |