Individual
MICHAEL ROBERT DAUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3333 BURNET AVE, ML 5037, CINCINNATI, OH 45229-3026
(513) 636-4975
(513) 636-6753
Mailing address
3333 BURNET AVE, ML 5037, CINCINNATI, OH 45229-3026
(513) 636-4975
(513) 636-6753
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
35.133607
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/01/2013
Last updated
02/12/2020
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