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Individual

MARY E. DOHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1221 MAIN ST, SOUTH WEYMOUTH, MA 02190-1561
(781) 340-1702
(781) 340-0931
Mailing address
1221 MAIN ST, SOUTH WEYMOUTH, MA 02190-1561
(781) 340-1702
(781) 340-0931

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
105977
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NP3038
BLUE CROSS BLUE SHIELD
MA
Enumeration date
12/30/2005
Last updated
10/22/2007
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