Individual
JOSEPH DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(262) 329-1000
(262) 329-1001
Mailing address
4025 N 92ND ST, WAUWATOSA, WI 53222-1613
(414) 358-5420
(414) 329-1001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
67554
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457746448
—
WI
Enumeration date
04/06/2015
Last updated
12/01/2021
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