Individual
CHARLES O DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
62 SOUTH MAIN STREET, YARDLEY, PA 19067
(215) 493-5535
Mailing address
62 SOUTH MAIN STREET, YARDLEY, PA 19067
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD420232
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019534830001
—
PA
Enumeration date
06/30/2006
Last updated
02/08/2011
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