Individual provider · Type 1 NPI
Sean Michael Dougherty, D.P.M.
Foot & Ankle Surgery Podiatrist · Fairfield, CA
NPI number
1407089261
Active
Practice location
1620 Pennsylvania Ave Ste A
Fairfield, CA 94533-3509
Fax (707) 426-3156
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist | 213E00000X | E5009 (CA) |
| Primary Podiatric Medicine Podiatrist | 213EP1101X | E5009 (CA) |
| Sports Medicine Podiatrist | 213ES0000X | E5009 (CA) |
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | E5009 (CA) |
Foot & Ankle Surgery Podiatrist: Definition to come...
2 other providers at this address
Other foot & ankle surgery podiatrist providers in Fairfield
About NPI 1407089261
Sean Michael Dougherty, D.P.M.'s National Provider Identifier is 1407089261, issued on Aug 27, 2009. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Fairfield, CA. The record was last updated on Sep 2, 2020.