Individual
DR. THOMAS H DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 MEDICAL CENTER DR, SUITE B510, HUNTINGTON, WV 25701-3656
(304) 691-8850
(304) 523-9470
Mailing address
1600 MEDICAL CENTER DR, SUITE B510, HUNTINGTON, WV 25701-3656
(304) 691-8850
(304) 523-9470
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
22471
WV
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
22471
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2694866
—
OH
05
—
3810006887
—
WV
Enumeration date
12/06/2005
Last updated
10/24/2012
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