Individual provider · Type 1 NPI

Glen A. Doherty, MD PHD

Student in an Organized Health Care Education/Training Program · Boston, MA

NPI number 1407094451 Active

Practice location

330 Brookline Ave, Bidmc, Gi, Division, E/DANA-501
Boston, MA 02215-5400

Call (617) 735-2929 Map

Fax (617) 735-2930

Mailing address

1330 Boylston St, Apt 614
Boston, MA 02215-4229

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X237937 (MA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1407094451

Glen A. Doherty, MD PHD's National Provider Identifier is 1407094451, issued on Jan 29, 2009. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Boston, MA. The record was last updated on Jan 29, 2009.