Provider Demographics
NPI:1083634448
Name:FLAHERTY, DAVID H (DMSC, PA-C)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:H
Last Name:FLAHERTY
Suffix:
Gender:M
Credentials:DMSC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 S PATTEN RD
Mailing Address - Street 2:
Mailing Address - City:PATTEN
Mailing Address - State:ME
Mailing Address - Zip Code:04765-3007
Mailing Address - Country:US
Mailing Address - Phone:207-538-3700
Mailing Address - Fax:207-528-2880
Practice Address - Street 1:188 SUMMER ST
Practice Address - Street 2:
Practice Address - City:DOVER FOXCROFT
Practice Address - State:ME
Practice Address - Zip Code:04426-1129
Practice Address - Country:US
Practice Address - Phone:207-523-3700
Practice Address - Fax:207-528-2880
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA1263363A00000X
MDC0001498363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS70372Medicare UPIN
MDC001Medicare ID - Type Unspecified