Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 18934 | NE |
NPI | 1427163609 |
---|---|
Provider Name | Dr. Carolyn Maud Doherty |
First Address | Omaha, NE 68103-2797 |
Second Address | Elkhorn, NE 68022-3913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 17/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10024995600 | (05) | NE |
1427163609 | (05) | IA |
90871 | (05) | IA |
E18773 | (02) |