Individual
DR. THEODORE BRIAN DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-2537
Mailing address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
19301
CA
207P00000X
Emergency Medicine Physician
Primary
OT018402
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OT018402
—
PA
Enumeration date
05/29/2018
Last updated
05/12/2022
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