Dougherty, Miriam Theresa
Dougherty, Miriam Theresa is an sole proprietor health care provider with primary practice located at 2000 Washington St Ste 206 , Newton MA 02462-1602. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Dougherty, Miriam Theresa can be contacted via phone (617) 332-6311.Contact Information
Primary practice address
2000 Washington St Ste 206
Newton MA 02462-1602
Phone: (617) 332-6311
Fax: (617) 243-5650
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MA46091 | Massachusetts |
Profile Details
| NPI number | 1407073653 |
|---|---|
| LBN Legal business name | Dougherty, Miriam Theresa |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 19th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1407073653 | NPPES |
| Massachusetts | MEDICAID | 6173624 | |
| Massachusetts | Other | MA46091 |
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