Individual
DR. REZA J DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0816
(434) 924-9400
(434) 982-1618
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
C10007905
DE
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
C10007905
DE
2085P0229X
Pediatric Radiology Physician
0101264628
VA
2085R0202X
Diagnostic Radiology Physician
Primary
0101264628
VA
2085R0202X
Diagnostic Radiology Physician
C10007905
DE
2085R0202X
Diagnostic Radiology Physician
MD419063
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001830
—
NJ
05
—
1184716938
—
VA
05
—
4100646
—
MD
Enumeration date
09/29/2006
Last updated
11/24/2025
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