Individual
DR. MATTHEW JOSEPH DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 SPRUCE ST, STE 101, PHILADELPHIA, PA 19106-0423
(215) 829-5000
(215) 627-0578
Mailing address
700 SPRUCE ST, STE 101, PHILADELPHIA, PA 19106-0423
(215) 829-5000
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD646443L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013019490001
—
PA
Enumeration date
01/12/2007
Last updated
09/11/2012
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