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Individual
THOMAS C DOUGHERTY
Active
Individual
THOMAS C DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN.CNP.09529
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.09529
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2804022
—
OH
05
—
7100019060
—
KY
01
—
CC2432
RAILROAD MEDICARE
KY
01
—
CC2433
RAILROAD MEDICARE
OH
Enumeration date
08/16/2007
Last updated
07/25/2019
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