Provider Demographics
NPI:1679510903
Name:LAHEY, MICHAEL DUANE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DUANE
Last Name:LAHEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 S 8TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-4560
Mailing Address - Country:US
Mailing Address - Phone:970-522-2264
Mailing Address - Fax:970-522-2272
Practice Address - Street 1:1405 S 8TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-4560
Practice Address - Country:US
Practice Address - Phone:970-522-2264
Practice Address - Fax:970-522-2272
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM5743174400000X
CODR-27410207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002913000Medicaid
IDD28408Medicare UPIN
ID1132214Medicare ID - Type Unspecified
ID002913000Medicaid