Provider Demographics
NPI:1457048100
Name:FLAHERTY, MICHAEL D
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:D
Last Name:FLAHERTY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 SPRINGWOOD LAKE DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-7005
Mailing Address - Country:US
Mailing Address - Phone:614-475-3442
Mailing Address - Fax:
Practice Address - Street 1:546 SPRINGWOOD LAKE DR
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-7005
Practice Address - Country:US
Practice Address - Phone:614-475-3442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker