Timothy Dougherty
Emergency Medicine in Cape Coral, FL. Individual provider (NPI-1).
NPI number1164487344
StatusActive
Last updated in NPPESJan 3, 2008
Details
- NPI
- 1164487344
- Entity type
- Individual (NPI-1)
- Name
- Timothy Dougherty
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 19, 2006
- Last updated
- Jan 3, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | ME76221 | FL | Yes |
Practice location
636 Del Prado Blvd SCape Coral, FL 33990-2668
Phone 239-772-6513
Mailing address
6896 W Snowville RdBrecksville, OH 44141-3214
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