Provider Demographics
NPI:1992772891
Name:FLYNN, ANNE BOTHWELL (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:BOTHWELL
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:B
Other - Last Name:SCHILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 30309
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29417-0309
Mailing Address - Country:US
Mailing Address - Phone:843-554-9300
Mailing Address - Fax:843-566-8780
Practice Address - Street 1:316 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1113
Practice Address - Country:US
Practice Address - Phone:843-724-2260
Practice Address - Fax:843-727-3631
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27801207ZC0500X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC278015Medicaid
SCAA12161994Medicare PIN
SCAA12165077Medicare PIN
SCAA12165831Medicare PIN
SCAA12161993Medicare PIN
SC278015Medicaid
SCP00289138Medicare PIN