Individual
DONN M DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
760 PILGRIM WAY, GREEN BAY, WI 54304-5263
(920) 496-4700
Mailing address
760 PILGRIM WAY, GREEN BAY, WI 54304-5263
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28871-020
WI
207Q00000X
Family Medicine Physician
DD406638
MI
Other
Enumeration date
07/03/2006
Last updated
02/26/2010
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