Provider Demographics
NPI:1477880276
Name:FLANAGAN, SIOBHAN MOIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:SIOBHAN
Middle Name:MOIRA
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5825 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-3113
Mailing Address - Country:US
Mailing Address - Phone:612-590-7711
Mailing Address - Fax:
Practice Address - Street 1:MMC 292,420 DELAWARE STREET SE,
Practice Address - Street 2:UNIVERSITY OF MINNESOTA DEPARTMENT OF RADIOLOGY
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-5589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN02085R0202X
MN527762085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology