Individual
DR. TIMOTHY RUSSELL DOUGHERTY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4660 KENMORE AVE STE 100, ALEXANDRIA, VA 22304-1306
(703) 751-5763
(703) 370-8704
Mailing address
4660 KENMORE AVE STE 100, ALEXANDRIA, VA 22304-1306
(703) 751-5763
(703) 370-8704
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD039006
DC
207RG0100X
Gastroenterology Physician
Primary
0101261949
VA
207RG0100X
Gastroenterology Physician
MD039006
DC
Other
Enumeration date
07/17/2008
Last updated
07/21/2022
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