Individual
RACHEL ELLEN DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2400 17TH ST, COLUMBUS, IN 47201-5351
(812) 376-5322
Mailing address
PO BOX 1329, COLUMBUS, IN 47202-1329
(812) 418-0014
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01085333A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11019499A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11019499A
—
IN
Enumeration date
06/18/2017
Last updated
10/20/2022
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