MICHAEL R DOUGHERTY (NPI# 1538443908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538443908 |
| Entity Type | Individual |
| Full Name | MICHAEL R DOUGHERTY |
| Credential | DC |
| Practice Address |
9331 Old Bustleton Ave 101 Philadelphia PA 19115-4204 |
| Mailing Address |
9331 Bustleton Avenue Suite 101 Philadelphia PA 19115 |
| Practice Telephone | 2152518526 |
| Practice Fax Number | 2156731980 |
| Mailing Telephone | 2152518526 |
| Mailing Fax Number | 2156731980 |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2016-02-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 38MC00695600 | NJ | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881139939 | Michael Dougherty | Obstetrics & Gynecology | 913 Village Drive West, North Brunswick, NJ 08902 | 2016-12-28 |
| 1114160439 | Michael Christopher Dougherty | Emergency Medical Technician, Paramedic | Psc 37, Box 4813, Apo, AE 09459-9998 | 2009-04-16 |
| 1720276579 | Michael Dougherty | Physical Therapist | 9441 Lbj Fwy Ste 101, Dallas, TX 75243-4566 | 2007-10-05 |
| 1790997781 | Michael W Dougherty | Audiologist | 211 South St # 318, Philadelphia, PA 19147-2305 | 2007-05-04 |
| 1134228265 | Michael James Dougherty | Pediatrics | 200 Patewwod Drive, Suite A200, Greenville, SC 29615-3585 | 2006-09-22 |
| 1932186210 | Michael D Dougherty | Physician Assistant | 611 Sherman Ave East, Fort Atkinson, WI 53538 | 2005-12-28 |
| 1972129476 | Michael Devin Dougherty | Nurse Practitioner | 1690 N Monroe St, Tallahassee, FL 32303-5533 | 2020-06-19 |
| 1437786407 | Michael Dougherty | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2020-03-26 |
| 1245735133 | Michael James Dougherty | Student in an Organized Health Care Education/Training Program | 3401 North Blvd Ste 200, Baton Rouge, LA 70806-3743 | 2018-03-24 |
| 1679904999 | Michael Dougherty | Specialist/Technologist | 5165 Adanson St, Orlando, FL 32804-1331 | 2013-12-12 |
| Street Address |
9331 OLD BUSTLETON AVE 101 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19115-4204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285632802 | Thomas J Cullen Jr. | Psychologist | 9331 Old Bustleton Ave, Suite 101, Philadelphia, PA 19115-4634 | 2005-07-08 |
| 1902200876 | Tri-state Sport and Spine, Pllc | Chiropractor | 9331 Old Bustleton Ave, Suite 101, Philadelphia, PA 19115-4204 | 2014-10-21 |
| 1205245040 | Temple Physicians Inc | Family Medicine | 9331 Old Bustleton Ave, Suite 202, Philadelphia, PA 19115-4204 | 2014-08-06 |
| 1164841946 | Temple Physicians Inc | Emergency Medicine | 9331 Old Bustleton Ave, Suite 100a, Philadelphia, PA 19115-4204 | 2014-04-09 |
| 1598188401 | Carla S Cuoci-malin | Family Medicine | 9331 Old Bustleton Ave, Suite100a, Philadelphia, PA 19115-4204 | 2014-01-28 |
| 1770740599 | Parkwood Family Chiropractic, Inc. | Chiropractor | 9331 Old Bustleton Ave, Suite 101, Philadelphia, PA 19115-4204 | 2008-05-20 |
| 1457489320 | Temple Physicians Inc. | Obstetrics & Gynecology | 9331 Old Bustleton Ave, 2nd Floor, Philadelphia, PA 19115-4634 | 2007-03-01 |
| 1841334109 | Cullen Psychological Services, PC | Psychologist | 9331 Old Bustleton Ave, Suite 101, Philadelphia, PA 19115-4634 | 2007-02-19 |
| 1427100304 | Temple Physicians Inc. | Internal Medicine | 9331 Old Bustleton Ave, Suite 201, Philadelphia, PA 19115-4634 | 2007-01-18 |
| 1073665428 | Temple Physicians Inc. | Obstetrics & Gynecology | 9331 Old Bustleton Ave, Suite 101, Philadelphia, PA 19115-4634 | 2007-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442696 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 2044 Red Lion Road, Philadelphia, PA 19115 | 2020-09-21 |
| 1639717762 | Cassondra Ondeck | Physical Therapist | Paul's Run Retirement Community, 9896 Bustleton Ave, Philadelphia, PA 19115 | 2019-12-19 |
| 1740747641 | Comfort Ride Transit Inc | Non-emergency Medical Transport (VAN) | 248 Geiger Road, Suite 201 Unit D, Philadelphia, PA 19115 | 2019-02-27 |
| 1386101400 | Ashley Thomas | Physician Assistant | 9331 Old Bustleton Ave Ste 100a, Philadelphia, PA 19115 | 2019-02-25 |
| 1659857027 | Kiesha Anita Abney | Occupational Therapy Assistant | Chapel Manor (genesis Rehabilitation) 1104 Welsh Road, Philadelphia, PA 19115 | 2018-07-18 |
| 1457844870 | Philadelphia Discount Pharmacy LLC | Pharmacist | 842 Red Lion Road Unit 13, Philadephia, PA 19115 | 2018-06-11 |
| 1770001828 | Ciarra Bell | Occupational Therapist | 828 Red Lion Rd, Philadelphia, PA 19115 | 2017-09-08 |
| 1245604008 | Saria Ibrahim | Counselor | 9651 Clark Street, Philadelphia, PA 19115 | 2015-11-17 |
| 1124413166 | Global Dental Plus LLC | Dentist | 9630 Bustleton Av 2nd Fl, Philadelphia, PA 19115 | 2015-04-06 |
| 1932510161 | Miriam John | Occupational Therapist | 9997 Sandy Road, Philadelphia, PA 19115 | 2014-05-09 |
| Find all providers in zip 19115 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124628540 | Citywide North, PC | Chiropractor | 2304-a North Broad Street, Philadelphia, PA 19132-4563 | 2020-10-26 |
| 1598313488 | Dev Avinash Rajhansa | Chiropractor | 101 W Allens Ln, Philadelphia, PA 19119-4101 | 2019-09-03 |
| 1861059859 | Joshua James Kramarenko | Chiropractor | 1608 Walnut St Ste 601, Philadelphia, PA 19103-5447 | 2019-05-24 |
| 1306409024 | Danielle Louise Walsh | Chiropractor | 3500 Scotts Ln Ste 215, Philadelphia, PA 19129-1836 | 2019-04-18 |
| 1952868804 | Yoon Sang Song | Chiropractor | 6115 Woodland Ave, Philadelphia, PA 19142-2418 | 2019-02-27 |
| 1104381011 | Anthony James Havens Jr. | Chiropractor | 6006 Chestnut St Fl 1, Philadelphia, PA 19139-3044 | 2019-02-05 |
| 1750851390 | Philadelphia Pain and Neurology Institute, LLC | Chiropractor | 1528 Walnut Street Suite 620, Philadelphia, PA 19102 | 2018-11-27 |
| 1710467626 | Darin Mathew Daniel | Chiropractor | 2216 W Passyunk Ave, Philadelphia, PA 19145-3318 | 2018-08-20 |
| 1780184952 | Chelsea Ann Mclane | Chiropractor | 430 Green Ln, Philadelphia, PA 19128-3304 | 2018-02-14 |
| 1881193860 | Pa Pain and Rehab | Chiropractor | 6325 Woodland Avenue, Philadelphia, PA 19142 | 2018-02-06 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19115 |
Please comment or provide details below to improve the information on MICHAEL R DOUGHERTY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.