Individual
MICHAEL DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
13889
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119624
—
MS
05
—
180300
—
AL
01
—
300085749
RAILROAD MEDICARE
MS
01
—
512G700003
MS MEDICARE - GROUP
MS
01
—
DC7781
RAILROAD MEDICARE GROUP #
—
01
—
P00601123
RAILROAD MEDICARE
—
01
—
P01194855
RAILROAD MEDICARE PTAN
MS
Enumeration date
07/07/2006
Last updated
01/27/2016
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