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1194717926
CHARLES DOUGHERTY
RESTON, VA
NPI
1194717926
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207L00000X Anesthesiology
(Licence: VA 0101233598)
Enumeration Date
2005-08-18
Last Update Date
2011-01-11
Business Address
-- CHARLES DOUGHERTY
1850 TOWN CENTER PKWY
RESTON, VA 20190-3219
Phone number: 703-471-0919
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Mailing Address
-- CHARLES DOUGHERTY
11341 SUNSET HILLS RD
RESTON, VA 20190-5205
Phone number: 703-471-0919
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