Individual
DR. MICHAEL WAYNE DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 W COLUMBIA ST STE 420, EVANSVILLE, IN 47710
(812) 422-3254
Mailing address
350 W COLUMBIA ST STE 420, EVANSVILLE, IN 47710-1782
(270) 314-5826
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01080455A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300014772
—
IN
05
—
7100547700
—
KY
Enumeration date
10/16/2012
Last updated
02/26/2024
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