Doherty, Michael G
Doherty, Michael G is an individual health care provider with primary practice located at 3264 N Evergreen Dr Ne , Grand Rapids MI 49525-9746. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Ultrasound, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Doherty, Michael G can be contacted via phone (616) 363-7339.Contact Information
Primary practice address
3264 N Evergreen Dr Ne
Grand Rapids MI 49525-9746
Phone: (616) 363-7339
Fax: (616) 361-5828
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | 42856 | Minnesota |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 4301087295 | Michigan |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 4301087295 | Michigan |
Profile Details
| NPI number | 1730154261 |
|---|---|
| LBN Legal business name | Doherty, Michael G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 20th, 2006 |
| Last updated | Jun 14th, 2012 - about 12 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 | 1730154261 | NPPES |
| Minnesota | MEDICAID | 604658400 |
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