Provider Demographics
NPI:1962439158
Name:FLAHERTY, MICHAEL E (DPM)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:FLAHERTY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5405 W HILLSDALE AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5156
Mailing Address - Country:US
Mailing Address - Phone:559-627-1850
Mailing Address - Fax:559-627-1723
Practice Address - Street 1:5405 W HILLSDALE AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5156
Practice Address - Country:US
Practice Address - Phone:559-627-1850
Practice Address - Fax:559-627-1723
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE2943213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5627190001Medicare NSC
CAT11526Medicare UPIN