Individual
DR. DAVID R DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
295 ESSJAY RD, WILLIAMSVILLE, NY 14221-8216
(716) 630-1045
(716) 630-1451
Mailing address
425 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-5782
(716) 630-1219
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
190466-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010047601
UNIVERA
NY
01
—
000523376001
HEALTH NOW
NY
05
—
01503039
—
NY
01
—
060030225
RR MEDICARE
NY
01
—
161000580
NORTH AMERICAN PREFERRED
NY
01
—
2504875
GHI
NY
01
—
2706325
IHA
NY
Enumeration date
04/26/2006
Last updated
12/10/2021
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