Flynn, Dedra M
Flynn, Dedra M is an individual health care provider with primary practice located at 1330 Exchange St Suite 201, Middlebury VT 05753-4464. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Flynn, Dedra M can be contacted via phone (802) 388-7959.Contact Information
Primary practice address
1330 Exchange St Suite 201
Middlebury VT 05753-4464
Phone: (802) 388-7959
Fax: (802) 388-8136
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0420010996 | Vermont |
Profile Details
| NPI number | 1598754012 |
|---|---|
| LBN Legal business name | Flynn, Dedra M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2005 |
| Last updated | Dec 26th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598754012 | NPPES |
| New York | MEDICAID | 02681818 | |
| New York | MEDICAID | 1011760 |
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