Dougherty, Michael James

Dougherty, Michael James is an individual health care provider with primary practice located at 200 Patewwod Drive Suite A200, Greenville SC 29615-3585. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is his primary health care specialty. Dougherty, Michael James can be contacted via phone (864) 454-5125.

Contact Information

Primary practice address
200 Patewwod Drive Suite A200 Greenville SC 29615-3585
Phone: (864) 454-5125
Fax: (864) 241-9201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M4041 Texas
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 32324 South Carolina
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 32324 South Carolina

Profile Details

NPI number 1134228265
LBN Legal business name Dougherty, Michael James
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Mar 23rd, 2018 - about 6 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 1134228265 NPPES
South Carolina MEDICAID 323242

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