Individual
MICHAEL J DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
155 WILSON AVE, DEPT OF RADIATION ONCOLOGY, WASHINGTON, PA 15301-3336
(724) 223-3788
(724) 229-2055
Mailing address
2 HOT METAL ST, QUANTUM ONE, N431, PITTSBURGH, PA 15203-2348
(412) 432-5806
(712) 432-7691
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD042918L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014377780001
—
PA
05
—
0014377780002
—
PA
05
—
0014377780012
—
PA
05
—
0014377780020
—
PA
05
—
0014377780055
—
PA
01
—
11453237
CAQH
PA
01
—
199313
HIGHMARK BS
PA
05
—
2586769
—
OH
05
—
3810002147
—
WV
Enumeration date
01/27/2006
Last updated
04/06/2009
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