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Individual

EMILY S DOHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4348 ELECTRIC RD, ROANOKE, VA 24018-0720
(540) 769-0976
(540) 857-5390
Mailing address
102 HIGHLAND AVE SE, SUITE 104, ROANOKE, VA 24013-2256
(540) 985-8147

Taxonomy

Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
0101239245
VA
208000000X
Pediatrics Physician
Primary
0101239245
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010298423
VA
Enumeration date
07/20/2006
Last updated
11/02/2021
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