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Individual

DR. ROBERT MICHAEL DAUGHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1854 BROADWAY ST, CAPE GIRARDEAU, MO 63701-4553
(573) 271-2923
(888) 523-2655
Mailing address
454 WEST ST, FROHNA, MO 63748-9143
(573) 979-1809
(888) 523-2655

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO4199
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
016005170
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2004013247
MO
213ES0103X
Foot & Ankle Surgery Podiatrist
250
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016005170
IL
01
197250
BLUE CROSS BLUE SHEILD
MO
01
2474055
UNITEDHEALTHCARE
MO
05
307288506
MO
05
307288514
MO
01
5621628
FIRST HEALTH
MO
01
706133
HEALTHLINK
MO
Enumeration date
03/01/2006
Last updated
11/15/2022
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