Dougherty, Charles O

Dougherty, Charles O is an individual health care provider with primary practice located at 62 South Main Street , Yardley PA 19067. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Dougherty, Charles O can be contacted via phone (215) 493-5535.

Contact Information

Primary practice address
62 South Main Street Yardley PA 19067
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD420232 Pennsylvania

Profile Details

NPI number 1376572792
LBN Legal business name Dougherty, Charles O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Feb 8th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376572792 NPPES
Pennsylvania MEDICAID 0019534830001

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