Healthcare Provider Details

I. General information

NPI: 1528005238
Provider Name (Legal Business Name): ROBERT F FLAHERTY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2696
US

IV. Provider business mailing address

311 SERVICE RD
EAST SANDWICH MA
02537-1370
US

V. Phone/Fax

Practice location:
  • Phone: 508-833-4000
  • Fax:
Mailing address:
  • Phone: 508-833-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number209849
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: