Individual
MATTHEW DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A88589
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
219515
BCBS
—
01
—
2700164
UHC
—
01
—
319419
GHP
—
01
—
6305736
CIGNA
—
01
—
72299V34311
HEALTHCARE USA
MO
01
—
7373873
AETNA
—
Enumeration date
06/21/2006
Last updated
09/21/2012
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