Provider Demographics
NPI:1700827086
Name:FLANNERY, WILLIAM K (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:K
Last Name:FLANNERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-8720
Mailing Address - Fax:704-384-8747
Practice Address - Street 1:16525 HOLLY CREST LN STE 150
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4911
Practice Address - Country:US
Practice Address - Phone:704-384-8720
Practice Address - Fax:704-384-8747
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9700549208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891043XMedicaid
SCN00549Medicaid
NC891043XMedicaid
NC2237987Medicare ID - Type Unspecified