Individual
JANET MARIE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3501 LOISDALE CT, SPRINGFIELD, VA 22150
(703) 359-7878
Mailing address
9409 B OLD BURKE LAKE RD, BURKE, VA 22015
(703) 978-4200
(703) 503-8263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101048216
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5617685
—
VA
Enumeration date
01/30/2006
Last updated
07/06/2021
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