Basic Information
| Provider Information | |||||||||
| NPI: | 1255564068 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLAHERTY | ||||||||
| FirstName: | DEVIN | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
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| Credential: | D.O., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 220 CAMPUS BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226012896 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405365100 | ||||||||
| FaxNumber: | 5405363471 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 CAMPUS BLVD STE 210 | ||||||||
| Address2: | |||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226016906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405363470 | ||||||||
| FaxNumber: | 5405363471 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2009 | ||||||||
| LastUpdateDate: | 02/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 0102204559 | VA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.