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1003481060
BRIAN DOUGHERTY
PROVIDENCE, RI
NPI
1003481060
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: RI LP05327)
Enumeration Date
2021-05-23
Last Update Date
2021-05-23
Business Address
BRIAN DOUGHERTY MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-444-4741
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Mailing Address
BRIAN DOUGHERTY MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-444-4741
Copy
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