Individual
DR. PATRICK DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1004 DRESSER CT, RALEIGH, NC 27609-7325
(919) 872-2022
Mailing address
1004 DRESSER CT STE 102, RALEIGH, NC 27609-7325
(919) 872-2022
(919) 872-2087
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
740
NC
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
740
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
740
NC
213ES0131X
Foot Surgery Podiatrist
740
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6712460018
MEDICARE NSC RALEIGH
NC
01
—
6712460024
MEDICARE NSC HENDERSON
NC
Enumeration date
02/02/2006
Last updated
10/19/2016
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