Dougherty, Sean Michael

Dougherty, Sean Michael is an individual health care provider with primary practice located at 1620 Pennsylvania Ave Ste A , Fairfield CA 94533-3509. He recently has 4 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Dougherty, Sean Michael can be contacted via phone (707) 426-5644.

Contact Information

Primary practice address
1620 Pennsylvania Ave Ste A Fairfield CA 94533-3509
Phone: (707) 426-5644
Fax: (707) 426-3156
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X E5009 California
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X E5009 California
Podiatric Medicine & Surgery Service Providers / Sports Medicine 213ES0000X E5009 California
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X E5009 California

Profile Details

NPI number 1407089261
LBN Legal business name Dougherty, Sean Michael
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2009
Last updated Sep 2nd, 2020 - about 4 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 1407089261 NPPES
California Other P01083197 MEDICARE RAILROAD

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