Individual
DR. KATIE DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2534 S 18TH ST, PHILADELPHIA, PA 19145-3701
(215) 463-4363
(215) 463-4365
Mailing address
2534 S 18TH ST, PHILADELPHIA, PA 19145-3701
(215) 463-4363
(215) 463-4365
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS008476L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01589896
—
PA
Enumeration date
07/05/2006
Last updated
01/14/2015
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