Individual
MAURA DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
101 ELM AVE SE, ROANOKE, VA 24013-2222
(301) 371-0501
Mailing address
5808 JEFFERSON BLVD, FREDERICK, MD 21703-6949
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/01/2025
Last updated
09/01/2025
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