Dougherty, Matthew Joseph

Dougherty, Matthew Joseph is an individual health care provider with primary practice located at 700 Spruce St Ste 101, Philadelphia PA 19106-0423. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Dougherty, Matthew Joseph can be contacted via phone (215) 829-5000.

Contact Information

Primary practice address
700 Spruce St Ste 101 Philadelphia PA 19106-0423
Phone: (215) 829-5000
Fax: (215) 627-0578
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X MD646443L Pennsylvania

Profile Details

NPI number 1225188840
LBN Legal business name Dougherty, Matthew Joseph
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2007
Last updated Sep 11th, 2012 - 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 1225188840 NPPES
Pennsylvania MEDICAID 0013019490001

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