Provider Demographics
NPI:1588603518
Name:FLATLEY, MICHAEL PATRICK (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PATRICK
Last Name:FLATLEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 ROUTE 44
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-4426
Mailing Address - Country:US
Mailing Address - Phone:856-241-1872
Mailing Address - Fax:856-241-1872
Practice Address - Street 1:356 ROUTE 44
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-4426
Practice Address - Country:US
Practice Address - Phone:856-241-1872
Practice Address - Fax:856-241-1872
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00268300213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ480034520OtherRAILROAD MEDICARE
NJ0033375Medicaid
NJ062397CU9Medicare PIN
NJ0033375Medicaid