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Individual

CHARLES A LYNN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 NOLTE DR, KITTANNING, PA 16201-7111
(724) 543-8405
(724) 543-8535
Mailing address
100 VISTA CIRCLE DRIVE, APARTMENT #413, PITTSBURGH, PA 15238
(412) 408-3512
(412) 281-6320

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD014978E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0007787900000
PA
01
126938
BLUE SHIELD
01
300050760
RR MEDICARE
Enumeration date
06/06/2006
Last updated
11/06/2008
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