Organization
INITIA NOVA DELAWARE LLC
Active
Other names
Initia Nova Delaware
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN WILLIAM DOUGHERTY III DO, MS (MEDICAL DIRECTOR)
(302) 256-0927
Entity
Organization
Contact information
Practice address
3512 SILVERSIDE RD STE 13, WILMINGTON, DE 19810-4913
(302) 256-0927
Mailing address
3512 SILVERSIDE RD STE 13, WILMINGTON, DE 19810-4913
(302) 256-0927
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
07/02/2025
Last updated
07/02/2025
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