Individual
DR. CAROLYN MAUD DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
717 N 190TH PLZ, SUITE # 2500, ELKHORN, NE 68022-3913
(402) 815-1915
(402) 815-1065
Mailing address
PO BOX 2797, OMAHA, NE 68103-2797
(402) 354-4230
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
18934
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10024995600
—
NE
05
—
1427163609
—
IA
05
—
90871
—
IA
Enumeration date
08/20/2006
Last updated
12/17/2013
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