Organization
MINNESOTA ONCOLOGY HEMATOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS P FLYNN MD (PRESIDENT)
(612) 863-8585
Entity
Organization
Contact information
Practice address
480 OSBORNE RD NE, SUITE 220, FRIDLEY, MN 55432
(763) 786-1620
(763) 780-3099
Mailing address
480 OSBORNE RD NE, SUITE 220, FRIDLEY, MN 55432
(763) 786-1620
(763) 780-3099
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
1076
MN
207RX0202X
Medical Oncology Physician
1076
MN
207VX0201X
Gynecologic Oncology Physician
1076
MN
363L00000X
Nurse Practitioner
1076
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C01828
MEDICARE ID
MN
Enumeration date
04/21/2009
Last updated
10/07/2010
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