Individual
MR. JOHN G. DOHERTY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DCSW,LCSW-C
Contact information
Practice address
510 BUTLER AVE, VETERANS AFFAIRS MEDICAL CENTER, MARTINSBURG, WV 25401-9990
(304) 263-0811
(304) 262-1390
Mailing address
10612 AUGUST CT, WILLIAMSPORT, MD 21795-1442
(301) 223-5995
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
05888
MD
Other
Enumeration date
01/11/2006
Last updated
07/08/2007
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