Provider Demographics
NPI:1821210584
Name:FLAHERTY, MICHAEL PATRICK (MD, MS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PATRICK
Last Name:FLAHERTY
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 38399
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-1225
Mailing Address - Country:US
Mailing Address - Phone:502-497-1335
Mailing Address - Fax:502-497-1336
Practice Address - Street 1:6400 DUTCHMANS PKWY STE 335
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3370
Practice Address - Country:US
Practice Address - Phone:502-497-1335
Practice Address - Fax:502-497-1336
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39600207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50029485OtherPASSPORT HEALTH PLAN
KY7100126960Medicaid