Organization
PHILIP J DOHERTY MD FACC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP J DOHERTY M.D. (MD)
(617) 696-0430
Entity
Organization
Contact information
Practice address
100 HIGHLAND STREET, SUITE 106, MILTON, MA 02186-0268
(617) 696-0430
(617) 698-1625
Mailing address
100 HIGHLAND STREET, SUITE 106, MILTON, MA 02186-0268
(617) 696-0430
(617) 698-1625
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M12648
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/19/2007
Last updated
11/19/2007
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