Individual
ANNA MARY DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5210 E THOMPSON RD, INDIANAPOLIS, IN 46237-2085
(317) 782-7500
(317) 782-7515
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002330A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300007511
—
IN
Enumeration date
07/25/2017
Last updated
02/13/2026
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