Individual
DR. MARK GERARD DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1625 N GEORGE MASON DR, SUITE 475, ARLINGTON, VA 22205-3683
(703) 717-4000
(703) 717-4009
Mailing address
1625 N GEORGE MASON DR, SUITE 475, ARLINGTON, VA 22205-3683
(703) 717-4000
(703) 717-4009
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
48014
TN
207VG0400X
Gynecology Physician
H4087
TX
207VG0400X
Gynecology Physician
MD60066893
WA
207VX0201X
Gynecologic Oncology Physician
Primary
0101257128
VA
207VX0201X
Gynecologic Oncology Physician
48014
TN
207VX0201X
Gynecologic Oncology Physician
H4087
TX
207VX0201X
Gynecologic Oncology Physician
MD 60066893
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000460A
—
OK
05
—
136867209
—
TX
05
—
136867213
—
TX
05
—
136867216
—
TX
05
—
136867505
—
TX
05
—
1467423871
—
VA
01
—
48014
TENNESSEE LICENSE
TN
01
—
8R1427
BCBS
TX
01
—
G8884737
MEDICARE - SNO CO
WA
01
—
H4087
MEDICAL LICENSURE
TX
Enumeration date
02/01/2006
Last updated
04/16/2015
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