Dougherty, Glen N
Dougherty, Glen N is an individual health care provider with primary practice located at 2001 Laurel St , Columbia SC 29204-1018. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Dougherty, Glen N can be contacted via phone (803) 254-3278.Contact Information
Primary practice address
2001 Laurel St
Columbia SC 29204-1018
Phone: (803) 254-3278
Fax: (803) 929-3256
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 28734 | South Carolina |
Profile Details
| NPI number | 1720021553 |
|---|---|
| LBN Legal business name | Dougherty, Glen N |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Aug 24th, 2021 - about 5 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 | 1720021553 | NPPES |
| South Carolina | MEDICAID | 287344 |
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