Provider Demographics
NPI:1669772836
Name:JAMES F FLAHERTY DO LLC
Entity type:Organization
Organization Name:JAMES F FLAHERTY DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:DIRSA
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-730-7335
Mailing Address - Street 1:23 SPRING STREET, SUITE B
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7011
Mailing Address - Country:US
Mailing Address - Phone:207-730-7335
Mailing Address - Fax:207-730-7325
Practice Address - Street 1:23 SPRING STREET, SUITE B
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7011
Practice Address - Country:US
Practice Address - Phone:207-730-7335
Practice Address - Fax:207-730-7325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1014207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B58073Medicare UPIN