Doherty, Gerald W
Doherty, Gerald W is an individual health care provider with primary practice located at 79 Kerwin Hill Rd , Norwich VT 05055-9475. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Doherty, Gerald W can be contacted via phone (802) 649-3225.Contact Information
Primary practice address
79 Kerwin Hill Rd
Norwich VT 05055-9475
Phone: (802) 649-3225
Fax: (802) 371-4488
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 055-0030712 | Vermont |
Profile Details
| NPI number | 1134114770 |
|---|---|
| LBN Legal business name | Doherty, Gerald W |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2005 |
| Last updated | Jun 3rd, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134114770 | NPPES |
| Vermont | MEDICAID | 9000203 |
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